Healthcare Provider Details

I. General information

NPI: 1881683910
Provider Name (Legal Business Name): KATHRYN M VRANICH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OAK ST
BUFFALO NY
14203-2215
US

IV. Provider business mailing address

850 N BLOSSOM RD
ELMA NY
14059-9642
US

V. Phone/Fax

Practice location:
  • Phone: 716-856-4202
  • Fax: 716-332-3570
Mailing address:
  • Phone: 716-668-9621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number012961
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: