Provider Demographics
NPI:1144575069
Name:CAMIZZI, DEANNA LOUISE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:LOUISE
Last Name:CAMIZZI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8731 ZIMMERMAN RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-7146
Mailing Address - Country:US
Mailing Address - Phone:716-532-3325
Mailing Address - Fax:
Practice Address - Street 1:10674 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GOWANDA
Practice Address - State:NY
Practice Address - Zip Code:14070-1344
Practice Address - Country:US
Practice Address - Phone:716-532-3325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002579-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist