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General NPI Number Information
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NPI Number | 1558678904
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Entity Type | Individual
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Provider Name | MARY R. WARREN O.T.R.
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Gender | Female
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 2590 W SENECA TPKE
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City | MARCELLUS
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State | NY
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Zip | 13108-9735
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Country | US
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Telephone | 315-673-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 2590 W SENECA TPKE
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City | MARCELLUS
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State | NY
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Zip | 13108-9735
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Country | US
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Telephone | 315-673-4034
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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 | 001430-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 001430-1
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License Number State | NY
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