Provider Demographics
NPI:1326037466
Name:ALFANO, TERESA REGINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:REGINA
Last Name:ALFANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-2015
Mailing Address - Country:US
Mailing Address - Phone:716-883-2838
Mailing Address - Fax:
Practice Address - Street 1:101 OAK ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-2215
Practice Address - Country:US
Practice Address - Phone:716-856-4202
Practice Address - Fax:716-332-3570
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00030115901OtherSENIOR CHOICE
NY000670126001OtherCOMMUNITY CARE
NY000670126001OtherFAMILY HEALTH PLUS
NY000670126001OtherCHILD HEALTH
NY00030115901OtherUNIVERA
NY00030115902OtherCHOICE CARE
NY000670126001OtherBC/BS TRADITIONAL
NY000670126001OtherHEALTH NOW
NY000670126001OtherCOMMUNITY BLUE
NY00639487Medicaid
NY9390385OtherINDEPENDENT HEALTH
NY000670126001OtherBC/BS TRADITIONAL
NY000670126001OtherFAMILY HEALTH PLUS