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General NPI Number Information
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NPI Number | 1487563466
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Entity Type | Individual
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Provider Name | MADISON REYNOLDS
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 37 N CHEMUNG ST
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City | WAVERLY
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State | NY
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Zip | 14892-1211
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Country | US
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Telephone | 607-565-2861
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Fax |
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Provider Business Mailing Address
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Address Line | 209 ONEIDA PL
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City | CORNING
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State | NY
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Zip | 14830-1407
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Country | US
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Telephone | 607-426-6566
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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 | 029616
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License Number State | NY
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