Restore Occupational and Physical Therapy Speech Language
Organization Active NPI Contractor · Cohoes, NY
NPI 1679946586 · NPPES record last updated Apr 14, 2016
Key facts
- NPI
- 1679946586
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Contractor 171W00000X
- Legal business name
- RESTORE OCCUPATIONAL AND PHYSICAL THERAPY SPEECH LANGUAGE
- Practice address
- 81 Mohawk St
Cohoes, NY 12047-2809 - Phone
- (518) 235-2329
- Fax
- (518) 235-9791
- NPI assigned
- Nov 2, 2015
- Organization subpart
- No
Authorized official
- Name
- Jodi A. Hague
- Title
- Administrator
- Phone
- (518) 235-2329
Practitioners 30
-
Lisa Ahrberg, OTR
-
Nancy J. Allen, M.A.,CCC/SLP
-
Amy Marie Devito, OTR/L
-
Pamela Duell, PT
-
Erica Grim, PT, DPT
-
Debra Guarneri, OTR/L
-
Kristen Marie Hausler, MS CCC-SLP
-
Ralph Anthony La Casio, OTRL
-
Michele Lynn Muller, MOT/L
-
Kim Rowland, L-SLP
-
Mona Tamakuwala, OTR/L
-
Patricia K Yates, SLP
-
Jeffrey George Mansfield, M.S.P.T.
-
Rosemary Christiansen Shaw, CCC/SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190903003123 | NY | Part B Supplier - Clinic/Group Practice | 5991003428 |
Receives reassigned benefits from 22 practitioners Practice locations: Cohoes, NY |
National Provider Directory
Locations
81 Mohawk St
Cohoes, NY 12047
Phone (518) 220-9933
690 Route 9
Gansevoort, NY 12831
Phone (518) 584-8172
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor |
171W00000X | NY | Yes |
Addresses
Primary practice location
81 Mohawk St
Cohoes, NY 12047-2809
Mailing address
81 Mohawk St
PO Box 367
Cohoes, NY 12047-2809
Phone (518) 235-2329
Other providers in Cohoes, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2016. 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.