Provider Demographics
NPI:1720054729
Name:RHODUS, LEE PATRICK (OT)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:PATRICK
Last Name:RHODUS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 WINDFALL RD
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-9333
Mailing Address - Country:US
Mailing Address - Phone:716-376-8200
Mailing Address - Fax:585-973-3978
Practice Address - Street 1:1825 WINDFALL RD
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-9333
Practice Address - Country:US
Practice Address - Phone:716-376-8200
Practice Address - Fax:585-973-3978
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY842604OtherMANAGED PHYSICAL NETWORK
NY00011174501OtherUNIVERA
NY6697159OtherGHI
NY000670121001OtherBLUE CROSS BLUE SHIELD
NY9612936OtherIHA
NY000670121001OtherBLUE CROSS BLUE SHIELD