Healthcare Provider Details

I. General information

NPI: 1932785276
Provider Name (Legal Business Name): DANIEL C ANDERSON OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 EVERTS AVE
GLENS FALLS NY
12804-2040
US

IV. Provider business mailing address

37 EVERTS AVE
GLENS FALLS NY
12804-2040
US

V. Phone/Fax

Practice location:
  • Phone: 518-744-5680
  • Fax:
Mailing address:
  • Phone: 518-744-5680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number012932
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: