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NPI Code Detail

MEDICARE: TRACY ANN DOTY MOT, OTR/L

MEDICARE: TRACY ANN DOTY MOT, 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
1225X00000XOccupational Therapist0119-007072VA
2225X00000XOccupational Therapist021737-1NY

General Provider Information

NPI Number : 1407300825
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY ANN DOTY MOT, OTR/L
Provider Business Mailing Address
First Line : 1483 CORAL DR
Second Line :
City : FARMINGTON
State : NY
Zip : 14425-9056
Country : US
Telephone Number : 585-469-4822
Fax Number :
Provider Business Practice Location Address
First Line : 38 W CHURCH ST
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-2130
Country : US
Telephone Number : 585-421-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2016
Last Update Date : 10/17/2024

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