Healthcare Provider Details

I. General information

NPI: 1881175040
Provider Name (Legal Business Name): PAUL GRAUPMAN OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ISLAND COTTAGE RD
GREECE NY
14612-2312
US

IV. Provider business mailing address

349 GILLETT RD
SPENCERPORT NY
14559-2041
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-6100
  • Fax:
Mailing address:
  • Phone: 585-747-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number06999-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: