Provider Demographics
NPI:1013212471
Name:OPTIMAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:OPTIMAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ISABELLE
Authorized Official - Middle Name:DELIA
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:716-208-5754
Mailing Address - Street 1:99 STARIN AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2495 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2152
Practice Address - Country:US
Practice Address - Phone:716-836-5929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007224-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency