Provider Demographics
NPI:1669627733
Name:WASHELESKI, ANN MARGARET (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:MARGARET
Last Name:WASHELESKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARGARET
Other - Last Name:WASHELESKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:402 TYNAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:NY
Mailing Address - Zip Code:13042-2148
Mailing Address - Country:US
Mailing Address - Phone:315-675-3753
Mailing Address - Fax:
Practice Address - Street 1:1 ADLER DR
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-1223
Practice Address - Country:US
Practice Address - Phone:315-657-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009110-1172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist