MEDICARE: MR. WILLIAM I. OWENS III 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	225XP0019X	Physical Rehabilitation Occupational Therapist	028018-01	NY

General Provider Information

NPI Number	:	1376131730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM I. OWENS III OTR/L

Provider Business Mailing Address
First Line	:	321 LARCHMONT ACRES APT 1B
Second Line	:
City	:	LARCHMONT
State	:	NY
Zip	:	10538-7313
Country	:	US
Telephone Number	:	646-371-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 WAYNE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-1511
Country	:	US
Telephone Number	:	718-655-1700
Fax Number	:

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

Provider Enumeration Date	:	01/01/2021
Last Update Date	:	06/06/2023

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