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NPI Code Detail

MEDICARE: ELLEN BUNTS OTRL

MEDICARE: ELLEN BUNTS OTRL
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 Therapist011796-1NY

General Provider Information

NPI Number : 1568814556
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN BUNTS OTRL
Provider Business Mailing Address
First Line : 33 LEWIS RD
Second Line :
City : BINGHAMTON
State : NY
Zip : 13905-1048
Country : US
Telephone Number : 607-770-0025
Fax Number : 607-729-3982
Provider Business Practice Location Address
First Line : 33 LEWIS RD
Second Line :
City : BINGHAMTON
State : NY
Zip : 13905-1048
Country : US
Telephone Number : 607-770-0025
Fax Number : 607-729-3982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2016
Last Update Date : 07/01/2016

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Directions to “ ELLEN BUNTS OTRL” Practice Location

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