Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0017961 | NY |
Y | 225XH1200X | Occupational Therapist - Hand | 0017961 | NY |
NPI | 1013032168 |
---|---|
Provider Name | Audrey J Buck |
First Address | Dunkirk, NY 14048 |
Second Address | Dunkirk, NY 14048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 22/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0102688 | (05) | NY |