Provider Demographics
NPI:1750408597
Name:SPIESZ, GERALYN MARIE (OT)
Entity type:Individual
Prefix:
First Name:GERALYN
Middle Name:MARIE
Last Name:SPIESZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:GERALYN
Other - Middle Name:MARIE
Other - Last Name:SPEACHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:6301 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1051
Mailing Address - Country:US
Mailing Address - Phone:716-684-0400
Mailing Address - Fax:716-683-7028
Practice Address - Street 1:6301 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1051
Practice Address - Country:US
Practice Address - Phone:716-684-0400
Practice Address - Fax:716-683-7028
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006713225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB3813Medicare ID - Type Unspecified