MEDICARE: MS. SARAH BETH OZYCK OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT0527	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OT0527	OTHER	ME	ME LIC

General Provider Information

NPI Number	:	1023300597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH BETH OZYCK OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 34
Second Line	:
City	:	BAR MILLS
State	:	ME
Zip	:	04004-0034
Country	:	US
Telephone Number	:	207-929-3838
Fax Number	:

Provider Business Practice Location Address
First Line	:	554 RIVER RD
Second Line	:
City	:	HOLLIS CENTER
State	:	ME
Zip	:	04042-3516
Country	:	US
Telephone Number	:	207-727-3838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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