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NPI Code Detail

MEDICARE: HEIDI RICHTER OTR/L

MEDICARE: HEIDI RICHTER 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 Therapist024343-01NY

General Provider Information

NPI Number : 1265071625
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI RICHTER OTR/L
Provider Business Mailing Address
First Line : 966 BARTNICK RD
Second Line :
City : GENOA
State : NY
Zip : 13071-9764
Country : US
Telephone Number : 315-209-2404
Fax Number :
Provider Business Practice Location Address
First Line : 150 W END AVE APT 1M
Second Line :
City : NEW YORK
State : NY
Zip : 10023-5715
Country : US
Telephone Number : 212-600-4781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2020
Last Update Date : 01/03/2020

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