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General NPI Number Information
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NPI Number | 1629893516
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Entity Type | Individual
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Provider Name | KAILEY MAE PFALZER
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1001 RIDGE RD
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City | BUFFALO
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State | NY
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Zip | 14218-1755
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Country | US
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Telephone | 716-821-1903
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Fax |
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Provider Business Mailing Address
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Address Line | 2495 MAIN ST STE 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 | 716-836-6057
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 011647
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License Number State | NY
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