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NPI Code Detail

MEDICARE: THERESA MARIE SHIRTZ MS OTR/L

MEDICARE: THERESA MARIE SHIRTZ MS 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
1225X00000XOccupational Therapist030509NY

General Provider Information

NPI Number : 1174470199
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA MARIE SHIRTZ MS OTR/L
Provider Business Mailing Address
First Line : 2033 MACEDON CENTER RD
Second Line :
City : MACEDON
State : NY
Zip : 14502-9175
Country : US
Telephone Number : 585-704-1137
Fax Number :
Provider Business Practice Location Address
First Line : 590 FISHERS STATION DR STE 130
Second Line :
City : VICTOR
State : NY
Zip : 14564-9744
Country : US
Telephone Number : 585-924-7207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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