Healthcare Provider Details

I. General information

NPI: 1376768523
Provider Name (Legal Business Name): CAPITAL DISTRICT HAND PHYSICAL AND OCCUPATIONAL THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2007
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NOTT ST STE 105A
SCHENECTADY NY
12308-2589
US

IV. Provider business mailing address

1201 NOTT ST STE 105A
SCHENECTADY NY
12308-2589
US

V. Phone/Fax

Practice location:
  • Phone: 518-377-9227
  • Fax:
Mailing address:
  • Phone: 518-377-9227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number002636-1
License Number StateNY

VIII. Authorized Official

Name: RUTH ELIZABETH LEADLEY
Title or Position: OWNER
Credential: OTR,CHT
Phone: 518-377-9227