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General NPI Number Information
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NPI Number | 1780798918
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Entity Type | Individual
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Provider Name | KELLY A SIMMONS
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4635 UNION RD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-1851
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Country | US
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Telephone | 716-505-5700
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Fax | 716-633-9351
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Provider Business Mailing Address
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Address Line | 11069 ALLEN RD
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City | EAST CONCORD
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State | NY
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Zip | 14055-9702
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Country | US
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Telephone | 716-496-5763
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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 | 008184-1
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License Number State | NY
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