Healthcare Provider Details

I. General information

NPI: 1326270026
Provider Name (Legal Business Name): BARRY V HASSON OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 08/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MAPLEGROVE DR
CHURCHVILLE NY
14428-9359
US

IV. Provider business mailing address

3 MAPLEGROVE DR
CHURCHVILLE NY
14428-9359
US

V. Phone/Fax

Practice location:
  • Phone: 585-293-1866
  • Fax:
Mailing address:
  • Phone: 585-293-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number005126-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: