Provider Demographics
NPI:1700013059
Name:GRAZIANO, ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:GRAZIANO
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 1:1612 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-2649
Mailing Address - Country:US
Mailing Address - Phone:315-733-1361
Mailing Address - Fax:
Practice Address - Street 1:1612 SOUTH ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2649
Practice Address - Country:US
Practice Address - Phone:315-733-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-14
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006068-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist