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NPI Code Detail

MEDICARE: NICOLE LYNN MAHER MS, OTRL, CHT

MEDICARE: NICOLE LYNN MAHER MS, OTRL, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0126991NY
2225XH1200XHand Occupational Therapist0126991NY

General Provider Information

NPI Number : 1093831331
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LYNN MAHER MS, OTRL, CHT
Provider Business Mailing Address
First Line : 4 WASHINGTON STREET
Second Line :
City : SILVER CREEK
State : NY
Zip : 14136
Country : US
Telephone Number : 716-913-5211
Fax Number :
Provider Business Practice Location Address
First Line : 7755 ROUTE 83
Second Line :
City : SOUTH DAYTON
State : NY
Zip : 14138-9633
Country : US
Telephone Number : 716-913-5211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 10/01/2014

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