Provider Demographics
NPI:1629315528
Name:LATEER, CAROL A (OTR)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:LATEER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:BIGELOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 NOYES ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4400
Mailing Address - Country:US
Mailing Address - Phone:315-624-9470
Mailing Address - Fax:
Practice Address - Street 1:1001 NOYES ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4400
Practice Address - Country:US
Practice Address - Phone:315-624-9470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017127-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist