Angela Beth Kiklowicz, OT, CLT, LMT
Individual provider Active NPI Occupational Therapist · Bradford, NY
NPI 1669017109 · NPPES record last updated Nov 7, 2019
Key facts
- NPI
- 1669017109
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 010465 (NY)
- Practice address
- 3590 W Lake Rd
Bradford, NY 14815-9658 - Phone
- (607) 329-3184
- Fax
- (585) 396-6064
- NPI assigned
- Nov 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018575 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 018575 | NY | |
| Occupational Therapist |
225X00000X | 010465 | NY | Yes |
Addresses
Primary practice location
3590 W Lake Rd
Bradford, NY 14815-9658
Mailing address
3590 W Lake Rd
Bradford, NY 14815-9658
Phone (607) 329-3184
Other practice location 1
350 Parrish St
Canandaigua, NY 14424-1731
Phone (585) 509-0058
Other providers in Bradford, NY
All providers in Bradford, 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 Nov 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.