Healthcare Provider Details

I. General information

NPI: 1235019167
Provider Name (Legal Business Name): REGINA VALERO RUIZ OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 E HENRIETTA RD STE 500
ROCHESTER NY
14623-2655
US

IV. Provider business mailing address

298 E SQUIRE DR APT 2
ROCHESTER NY
14623-1865
US

V. Phone/Fax

Practice location:
  • Phone: 585-258-3811
  • Fax:
Mailing address:
  • Phone: 802-683-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number030518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: