Provider Demographics
NPI:1346678596
Name:SALLMEN, JUDY LYNNE GAMBINO (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:LYNNE GAMBINO
Last Name:SALLMEN
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 1:42 RANDOM KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1970
Mailing Address - Country:US
Mailing Address - Phone:585-598-3903
Mailing Address - Fax:
Practice Address - Street 1:42 RANDOM KNOLLS DR
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1970
Practice Address - Country:US
Practice Address - Phone:585-598-3903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002727-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics