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General NPI Number Information
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NPI Number | 1437352218
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Entity Type | Individual
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Provider Name | RENAY SUE POHLEVEN OTRL
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 1657 SUNSET AVE
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City | UTICA
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State | NY
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Zip | 13502-5415
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Country | US
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Telephone | 315-797-7392
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Fax | 315-734-9041
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Provider Business Mailing Address
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Address Line | 1999 NEWPORT RD
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City | POLAND
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State | NY
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Zip | 13431-1714
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Country | US
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Telephone | 315-845-8914
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 010445-1
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License Number State | NY
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