Provider Demographics
NPI:1225347461
Name:HOMMA, REIKO (OTR)
Entity Type:Individual
Prefix:
First Name:REIKO
Middle Name:
Last Name:HOMMA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:REIKO
Other - Middle Name:
Other - Last Name:SETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4429 CHESTNUT RIDGE RD APT 4
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3240
Mailing Address - Country:US
Mailing Address - Phone:716-691-3607
Mailing Address - Fax:
Practice Address - Street 1:7 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2523
Practice Address - Country:US
Practice Address - Phone:716-505-5630
Practice Address - Fax:716-505-5654
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016218225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist