=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437436136
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRIGHT BEGINNINGS THERAPY SERVICES OT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2011
-----------------------------------------------------
Last Update Date | 11/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5205 OAKWOOD DR
-----------------------------------------------------
City | NORTH TONAWANDA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14120-9618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-625-4002
-----------------------------------------------------
Fax | 716-625-4002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5205 OAKWOOD DR
-----------------------------------------------------
City | NORTH TONAWANDA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14120-9618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-625-4002
-----------------------------------------------------
Fax | 716-625-4002
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. LAURE KRUPCZYK
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 716-432-6268
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 003631-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------