MEDICARE: MS. SUSAN CALYER OT

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	006263	NY

General Provider Information

NPI Number	:	1649255779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN CALYER OT

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:	518-525-5634
Fax Number	:	518-649-4094

Provider Business Practice Location Address
First Line	:	1240 NEW SCOTLAND RD STE 100
Second Line	:
City	:	SLINGERLANDS
State	:	NY
Zip	:	12159-9222
Country	:	US
Telephone Number	:	518-475-1818
Fax Number	:	518-475-1736

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	03/09/2018

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