Healthcare Provider Details

I. General information

NPI: 1437216249
Provider Name (Legal Business Name): DEBORAH E PISKOR OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH E GOODROW OTR

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3021
US

IV. Provider business mailing address

3355 SUMMERSET CT
NORTH TONAWANDA NY
14120-1278
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-5040
  • Fax: 716-898-3259
Mailing address:
  • Phone: 716-693-7570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003619-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: