Healthcare Provider Details

I. General information

NPI: 1568122364
Provider Name (Legal Business Name): ADVANCED OCCUPATIONAL THERAPY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 02/20/2022
Certification Date: 02/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2132 ROUTE 20
EAST DURHAM NY
12423-1555
US

IV. Provider business mailing address

2132 ROUTE 20
EAST DURHAM NY
12423-1555
US

V. Phone/Fax

Practice location:
  • Phone: 518-239-4367
  • Fax:
Mailing address:
  • Phone: 518-239-4367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. BONNIE FISCHER-CAMARA
Title or Position: CEO/PRESIDENT
Credential: OTD, OTR/L
Phone: 518-239-4367