MEDICARE: MR. THOMAS DANIEL STEWART 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	225X00000X	Occupational Therapist	004296	NY

General Provider Information

NPI Number	:	1770884231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS DANIEL STEWART OTR/L

Provider Business Mailing Address
First Line	:	8 WOODGATE DR
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-3267
Country	:	US
Telephone Number	:	716-668-0490
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 WOODGATE DR
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-3267
Country	:	US
Telephone Number	:	716-668-0490
Fax Number	:

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

Provider Enumeration Date	:	11/15/2010
Last Update Date	:	11/15/2010

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