Tamara Sue Letina
Individual provider Active NPI Occupational Therapist · Perrysburg, NY
NPI 1104077700 · NPPES record last updated Dec 16, 2015
Key facts
- NPI
- 1104077700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 14792-1 (NY)
- Practice address
- 10714 North Rd
Perrysburg, NY 14129-9746 - Phone
- (716) 532-1049
- Fax
- (716) 532-0679
- NPI assigned
- Oct 2, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190624001671 | NY | Practitioner - Occupational Therapist in Private Practice | 2365776457 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14792-1 | NY | MD | Occupational Therapist |
| 014792 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monroe Ddso Clinic Pittsford | Current |
Accepting new patients |
Locations
44 Holland Ave
Fl 4
Albany, NY 12208
305 Main St
Binghamton, NY 13905
Phone (607) 729-1295
106 Pine St
Hamburg, NY 14075
Phone (716) 646-0048
1200 East and West Rd
Bldg 16
West Seneca, NY 14224
Phone (716) 517-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14792-1 | NY | Yes |
Addresses
Primary practice location
10714 North Rd
Perrysburg, NY 14129-9746
Mailing address
13963 S Hoffman Rd
Apt #1
Springville, NY 14141-9770
Phone (716) 262-6181
Other names
- Miss Tamara Sue Dotegowski
Other providers in Perrysburg, NY
- Shannon Marie Kasperek
- Paul Koerner
- Kristy Lynn Kohler
- Rose Maria Kruszka
- Kristy L Lauer
- Jennifer Dianne Livi
- Nicole Marie Marcoux
- Sandra K Moshier
- Judith Ann Nocek-Genung
- Shana Anne North
All providers in Perrysburg, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.