Provider Demographics
NPI:1891044418
Name:HAND & REHABILITATION SPECIALISTS OT PT SLP PLLC
Entity Type:Organization
Organization Name:HAND & REHABILITATION SPECIALISTS OT PT SLP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR CHT
Authorized Official - Phone:716-631-5224
Mailing Address - Street 1:5144 SHERIDAN DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4653
Mailing Address - Country:US
Mailing Address - Phone:716-631-5224
Mailing Address - Fax:716-631-5626
Practice Address - Street 1:5144 SHERIDAN DR STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4653
Practice Address - Country:US
Practice Address - Phone:716-631-5224
Practice Address - Fax:716-631-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY791512251H1200X
NY0120921225XH1200X
NY013248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty