Marchon Brooks, COTA

Individual provider Active NPI Occupational Therapy Assistant · Williamsville, NY

NPI 1639482201 · NPPES record last updated Jul 23, 2010

Key facts

NPI
1639482201
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
006307-1 (NY)
Practice address
4444 Bryant Stratton Way
Williamsville, NY 14221-6013
Phone
(176) 631-5777
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
006307-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Autistic Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 006307-1 NY Yes

Addresses

Primary practice location

4444 Bryant Stratton Way
Williamsville, NY 14221-6013

Mailing address

4444 Bryant Stratton Way
Williamsville, NY 14221-6013
Phone (176) 631-5777

Other providers in Williamsville, NY

All providers in Williamsville, NY · Occupational Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.