Provider Demographics
NPI:1801044904
Name:BRESSLER, TIMOTHY A (OTA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:A
Last Name:BRESSLER
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PLEASANTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14572-1219
Mailing Address - Country:US
Mailing Address - Phone:585-735-5994
Mailing Address - Fax:
Practice Address - Street 1:15 PLEASANTSIDE DR
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:NY
Practice Address - Zip Code:14572-1219
Practice Address - Country:US
Practice Address - Phone:585-735-5994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64-007115224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant