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General NPI Number Information
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NPI Number | 1972753077
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Entity Type | Individual
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Provider Name | JULIE TARA COLANTONIO OTR
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Gender | Female
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 25 LIBERTY ST
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City | BATAVIA
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State | NY
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Zip | 14020-3246
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Country | US
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Telephone | 585-343-1840
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Fax | 585-343-2185
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Provider Business Mailing Address
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Address Line | 50 FARNSWORTH AVE
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City | OAKFIELD
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State | NY
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Zip | 14125-1130
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Country | US
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Telephone | 585-948-8321
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Fax | 585-343-1840
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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 | 015200
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License Number State | NY
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