Provider Demographics
NPI:1922468578
Name:KEITH, JOANNE RITZ (MS/OTR/L)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:RITZ
Last Name:KEITH
Suffix:
Gender:F
Credentials:MS/OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8935 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-1460
Mailing Address - Country:US
Mailing Address - Phone:716-957-2250
Mailing Address - Fax:
Practice Address - Street 1:8935 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NY
Practice Address - Zip Code:14057-1460
Practice Address - Country:US
Practice Address - Phone:716-957-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006621-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist