Provider Demographics
NPI:1295028280
Name:BRAYMAN, THERESA ANN (OT/L)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANN
Last Name:BRAYMAN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512-0129
Mailing Address - Country:US
Mailing Address - Phone:585-330-4622
Mailing Address - Fax:
Practice Address - Street 1:2350 STATE ROUTE 63
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:NY
Practice Address - Zip Code:14572-9509
Practice Address - Country:US
Practice Address - Phone:585-728-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006233225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist