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General NPI Number Information
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NPI Number | 1497927263
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Entity Type | Organization
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Legal Business Name | OPTIMAL OCCUPATIONAL AND PHYSICAL THERAPY ASSOCIATES SERVICES PLLC
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 2495 MAIN ST SUITE 234
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City | BUFFALO
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State | NY
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Zip | 14214-2152
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Country | US
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Telephone | 716-836-5929
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Fax |
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Provider Business Mailing Address
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Address Line | 2495 MAIN ST SUITE 234
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City | BUFFALO
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State | NY
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Zip | 14214-2152
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Country | US
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Telephone | 716-836-5929
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Fax |
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Authorized Official
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Title or Position | CHEIF FINANCIAL OFFICER
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Name | ELLEN STERNS-PAQUIN
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Credential | OTR/L
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Telephone | 716-836-5929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 011424-1
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License Number State | NY
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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 | 000209-1
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License Number State | NY
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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 | 003168-1
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License Number State | NY
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