Healthcare Provider Details

I. General information

NPI: 1821145608
Provider Name (Legal Business Name): PATRICIA ANN FATUROS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA ANN VOIGT OTR

II. Dates (important events)

Enumeration Date: 01/04/2007
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

105 SPICER CREEK RUN
GRAND ISLAND NY
14072-2187
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3235
  • Fax: 716-898-3259
Mailing address:
  • Phone: 716-773-5713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number006659
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: