Provider Demographics
NPI:1942687579
Name:PRN PHYSICAL & OCCUPATIONAL THERAPY NETWORK
Entity Type:Organization
Organization Name:PRN PHYSICAL & OCCUPATIONAL THERAPY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:585-727-1459
Mailing Address - Street 1:200 CASTLEBAR RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-2914
Mailing Address - Country:US
Mailing Address - Phone:585-256-3486
Mailing Address - Fax:
Practice Address - Street 1:20 PEACHTREE CT
Practice Address - Street 2:SUITE 105
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-4616
Practice Address - Country:US
Practice Address - Phone:631-467-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005442-1320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities