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1750706693 NPI number — AMANDA LEIGH PALLAR-SKORUSA MS, OTR

NPI Number: 1750706693
Health Care Provider/Practitioner: AMANDA LEIGH PALLAR-SKORUSA MS, OTR

Information about “1750706693” NPI (AMANDA LEIGH PALLAR-SKORUSA MS, OTR) exists in 1750706693 in HTML format HTML  |  1750706693 in plain Text format TXT  |  1750706693 in PDF (Portable Document Format) PDF  |  1750706693 in an XML format XML  formats.

NPI Number : 1750706693 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750706693",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PALLAR-SKORUSA",
    "FirstName": "AMANDA",
    "MiddleName": "LEIGH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, OTR",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "243 LAKE ST UNIT 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PENN YAN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14527-1812",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "315-246-8065",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9505 NORTHPOINTE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPRING",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77379-3799",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-766-8148",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/02/2014",
    "LastUpdateDate": "08/08/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225XP0019X",
          "TaxonomyName": "Physical Rehabilitation Occupational Therapist",
          "LicenseNumber": "018201",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225XP0019X",
          "TaxonomyName": "Physical Rehabilitation Occupational Therapist",
          "LicenseNumber": "124846",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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