Tammy Kelsey Perez, OTR/L

Individual provider Active NPI Occupational Therapist · Black River, NY

NPI 1790968469 · NPPES record last updated Dec 17, 2007

Key facts

NPI
1790968469
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
008991-1 (NY)
Practice address
30081 Nys Rte 3
Black River, NY 13612-2093
Phone
(315) 775-0525
NPI assigned
Dec 17, 2007
Sex
Female
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
008991-1NYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 008991-1 NY Yes

Addresses

Primary practice location

30081 Nys Rte 3
Black River, NY 13612-2093

Mailing address

30081 Nys Rte 3
Black River, NY 13612-2093
Phone (315) 775-0525

Other providers in Black River, NY

All providers in Black River, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.