Healthcare Provider Details

I. General information

NPI: 1992467112
Provider Name (Legal Business Name): SOFIE M PINNEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 W HILL RD
SHERBURNE NY
13460-4301
US

IV. Provider business mailing address

177 W HILL RD
SHERBURNE NY
13460-4301
US

V. Phone/Fax

Practice location:
  • Phone: 607-226-5673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number026067
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number026067
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: