Michael Vail

Individual provider Active NPI Occupational Therapist · Brooktondale, NY

NPI 1275935157 · NPPES record last updated Sep 22, 2014

Key facts

NPI
1275935157
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
P94821 (NY)
Practice address
217 Brooktondale Rd
Apt D
Brooktondale, NY 14817-9565
Phone
(315) 406-6149
NPI assigned
Sep 22, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P94821NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X P94821 NY Yes

Addresses

Primary practice location

217 Brooktondale Rd
Apt D
Brooktondale, NY 14817-9565

Mailing address

217 Brooktondale Rd
Apt D
Brooktondale, NY 14817-9565
Phone (315) 406-6149

Other providers in Brooktondale, NY

All providers in Brooktondale, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.