MEDICARE: SHARON WAGENER ZIMPFER

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	225X00000X	Occupational Therapist	008901-1	NY
2	225XM0800X	Mental Health Occupational Therapist	008901	NY

General Provider Information

NPI Number	:	1467566760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON WAGENER ZIMPFER

Provider Business Mailing Address
First Line	:	11 RICHMOND AVE
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-3028
Country	:	US
Telephone Number	:	716-816-2232
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FOREST AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-1207
Country	:	US
Telephone Number	:	716-816-2232
Fax Number	:

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/19/2019

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