Ethan Jacob Babcock

Individual provider Active NPI Physical Rehabilitation Occupational Therapist · Rome, NY

NPI 1467178558 · NPPES record last updated Oct 19, 2022

Key facts

NPI
1467178558
Entity type
Individual (NPI type 1)
Primary specialty
Physical Rehabilitation Occupational Therapist 225XP0019X
Practice address
600 W Embargo St
Rome, NY 13440-3153
Phone
(315) 360-8084
NPI assigned
Oct 19, 2022
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X Yes

Addresses

Primary practice location

600 W Embargo St
Rome, NY 13440-3153

Mailing address

600 W Embargo St
Rome, NY 13440-3153
Phone (315) 360-8084

Other providers in Rome, NY

All providers in Rome, NY · Physical Rehabilitation Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.