Healthcare Provider Details

I. General information

NPI: 1255112660
Provider Name (Legal Business Name): PATRICK LEVI SARSON OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 COPPER AVE NE
ALBUQUERQUE NM
87108-1301
US

IV. Provider business mailing address

7501 RIO SALADO CT NW # 87120
ALBUQUERQUE NM
87120-5323
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-7988
  • Fax:
Mailing address:
  • Phone: 505-515-7901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: