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General NPI Number Information
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NPI Number | 1841507779
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY KUMIEGA OTR
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Gender | Male
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 1123 VESTAL AVE
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City | BINGHAMTON
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State | NY
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Zip | 13903-1553
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Country | US
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Telephone | 607-762-8136
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Fax |
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Provider Business Mailing Address
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Address Line | 24 GREEN MEADOW LN
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City | BINGHAMTON
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State | NY
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Zip | 13901-6131
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Country | US
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Telephone | 607-648-2216
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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 | 010486-1
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License Number State | NY
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