Healthcare Provider Details

I. General information

NPI: 1952608598
Provider Name (Legal Business Name): BERNADETTE MARY FRANK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 DIVISION ST
NORTH TONAWANDA NY
14120-4461
US

IV. Provider business mailing address

6657 ROYAL PKWY N
LOCKPORT NY
14094-6647
US

V. Phone/Fax

Practice location:
  • Phone: 716-692-1049
  • Fax: 716-692-1875
Mailing address:
  • Phone: 716-434-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number008236-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: