MEDICARE: MADELYN DUZYK OTR/L

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
1	225XP0200X	Pediatric Occupational Therapist	OT010335	OH

General Provider Information

NPI Number	:	1104393636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELYN DUZYK OTR/L

Provider Business Mailing Address
First Line	:	2702 ERIE AVE STE 210
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 ERIE AVE STE 210
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2109
Country	:	US
Telephone Number	:	513-332-7243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	04/10/2026

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