1467430843 NPI number — OCCUPATIONAL THERAPY AND HAND REHABILITATION SERVICES, P.C.

Table of content: ROY T. WALKER PROVISIONAL LPC, PH. (NPI 1346799764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467430843 NPI number — OCCUPATIONAL THERAPY AND HAND REHABILITATION SERVICES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCCUPATIONAL THERAPY AND HAND REHABILITATION SERVICES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467430843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421-423 MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUNKIRK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14048-2720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-366-3417
Provider Business Mailing Address Fax Number:
716-366-3568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
421-423 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNKIRK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14048-2720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-366-3417
Provider Business Practice Location Address Fax Number:
716-366-3568
Provider Enumeration Date:
01/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUCK
Authorized Official First Name:
AUDREY
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRES/OWNER
Authorized Official Telephone Number:
716-366-3417

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0102688 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01026888 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com