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General NPI Number Information
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NPI Number | 1306115118
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Entity Type | Individual
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Provider Name | MARCIA N SHEA OTD, OTR
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Gender | Female
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 100 COLLEGE PKWY STE 100
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City | BUFFALO
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State | NY
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Zip | 14221-6800
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Country | US
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Telephone | 716-871-9915
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Fax | 716-362-1553
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Provider Business Mailing Address
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Address Line | 127 BOXELDER LN
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City | BUFFALO
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State | NY
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Zip | 14228-1351
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Country | US
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Telephone | 716-421-8375
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Fax | 716-362-1553
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32001750A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31005997A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 027263-01
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License Number State | NY
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