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NPI Code Detail

MEDICARE: MRS. JUDY ERICA MALINICH OTR

MEDICARE: MRS. JUDY ERICA MALINICH OTR
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
1174400000XSpecialist5046NC
2225X00000XOccupational Therapist017670-1NY

General Provider Information

NPI Number : 1134292782
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDY ERICA MALINICH OTR
Provider Business Mailing Address
First Line : 3767 DELAWARE AVE
Second Line :
City : KENMORE
State : NY
Zip : 14217-1040
Country : US
Telephone Number : 716-874-6175
Fax Number :
Provider Business Practice Location Address
First Line : 3767 DELAWARE AVE
Second Line :
City : KENMORE
State : NY
Zip : 14217-1040
Country : US
Telephone Number : 716-874-6175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 07/21/2022

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