Provider Demographics
NPI:1831336114
Name:UNITED DEVELOPMENTAL THERAPEUTICS
Entity type:Organization
Organization Name:UNITED DEVELOPMENTAL THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:607-669-4825
Mailing Address - Street 1:64 OCONNELL RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-6432
Mailing Address - Country:US
Mailing Address - Phone:607-237-8132
Mailing Address - Fax:
Practice Address - Street 1:64 OCONNELL RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-6432
Practice Address - Country:US
Practice Address - Phone:607-237-8132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005992-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency