Healthcare Provider Details

I. General information

NPI: 1578483475
Provider Name (Legal Business Name): NATALIE KOEPF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3767 DELAWARE AVE
KENMORE NY
14217-1040
US

IV. Provider business mailing address

940 THREE ROD RD
ALDEN NY
14004-9600
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-6175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number031270
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: