Provider Demographics
NPI:1780899740
Name:PFORSICH, JANIS LYNN (OTR)
Entity type:Individual
Prefix:MS
First Name:JANIS
Middle Name:LYNN
Last Name:PFORSICH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:NY
Mailing Address - Zip Code:12015-1422
Mailing Address - Country:US
Mailing Address - Phone:518-945-1830
Mailing Address - Fax:
Practice Address - Street 1:154 JEFFERSON HTS
Practice Address - Street 2:EDEN PARK RESTORATIVE THERAPY CENTER
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1215
Practice Address - Country:US
Practice Address - Phone:518-943-5151
Practice Address - Fax:518-943-9107
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2007-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013246-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist