Healthcare Provider Details

I. General information

NPI: 1083161350
Provider Name (Legal Business Name): AMY E. PRISCO-RING COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 09/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 TOWER DR STE 400
MIDDLETOWN NY
10941-2057
US

IV. Provider business mailing address

383 CHESTNUT AVE
NEW WINDSOR NY
12553-2104
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-4391
  • Fax:
Mailing address:
  • Phone: 845-546-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number009064-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: