1548576812 NPI number — MS. ALISON MARIE EISNOR-PITCHER MSOTR/L

Table of content: MS. ALISON MARIE EISNOR-PITCHER MSOTR/L (NPI 1548576812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548576812 NPI number — MS. ALISON MARIE EISNOR-PITCHER MSOTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EISNOR-PITCHER
Provider First Name:
ALISON
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSOTR/L
Provider Gender Code:
F

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:
1548576812
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMDEN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13316-1408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-264-2063
Provider Business Mailing Address Fax Number:
315-245-4074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13316-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-264-2063
Provider Business Practice Location Address Fax Number:
315-245-4074
Provider Enumeration Date:
08/25/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  011170-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 011170-1 . This is a "STATE OF NEW YORK EDUCATION DEPARTMENT - OFFICE OF PROFESSIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1049759 . This is a "NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC. (NBCOT)" identifier . This identifiers is of the category "OTHER".




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