Provider Demographics
NPI:1942518451
Name:CUNNINGHAM, CELESTINA G (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CELESTINA
Middle Name:G
Last Name:CUNNINGHAM
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 1:1307 TALMADGE HILL RD S
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NY
Mailing Address - Zip Code:14892-9515
Mailing Address - Country:US
Mailing Address - Phone:607-565-4935
Mailing Address - Fax:
Practice Address - Street 1:1 RAIDER LN
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2344
Practice Address - Country:US
Practice Address - Phone:607-739-5601
Practice Address - Fax:607-795-2445
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005335-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics