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General NPI Number Information
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NPI Number | 1548643364
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Entity Type | Individual
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Provider Name | CARRIE BETH PUNGER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 597 3RD AVE
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City | TROY
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State | NY
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Zip | 12182
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Country | US
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Telephone | 518-233-0544
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Fax |
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Provider Business Mailing Address
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Address Line | 7 IRVING RD
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City | SCOTIA
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State | NY
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Zip | 12302
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Country | US
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Telephone |
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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 | 023760-01
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License Number State | NY
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