Provider Demographics
NPI:1548576812
Name:EISNOR-PITCHER, ALISON MARIE (MSOTR/L)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:MARIE
Last Name:EISNOR-PITCHER
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13316-1408
Mailing Address - Country:US
Mailing Address - Phone:315-264-2063
Mailing Address - Fax:315-245-4074
Practice Address - Street 1:16 4TH ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NY
Practice Address - Zip Code:13316-1408
Practice Address - Country:US
Practice Address - Phone:315-264-2063
Practice Address - Fax:315-245-4074
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011170-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY011170-1OtherSTATE OF NEW YORK EDUCATION DEPARTMENT - OFFICE OF PROFESSIONS
1049759OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC. (NBCOT)