=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386882033
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHILDREN'S OCCUPATIONAL THERAPY RESOURCES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2009
-----------------------------------------------------
Last Update Date | 02/02/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6445 W QUAKER ST
-----------------------------------------------------
City | ORCHARD PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14127-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-667-9377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6445 W QUAKER ST
-----------------------------------------------------
City | ORCHARD PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14127-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-667-9377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOANNE NADINE LASKY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 716-667-9377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------