Provider Demographics
NPI:1467085712
Name:MCCOWN, AIDAN C (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:AIDAN
Middle Name:C
Last Name:MCCOWN
Suffix:
Gender:M
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 1:8344 WHEATON HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14572-9314
Mailing Address - Country:US
Mailing Address - Phone:585-490-0835
Mailing Address - Fax:
Practice Address - Street 1:311 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9798
Practice Address - Country:US
Practice Address - Phone:585-335-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020849-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist