Provider Demographics
NPI:1881903409
Name:KASPER, DENISE PAYNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:PAYNE
Last Name:KASPER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:PAYNE
Other - Last Name:KASPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6111 MARCUS WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-7018
Mailing Address - Country:US
Mailing Address - Phone:315-986-3069
Mailing Address - Fax:
Practice Address - Street 1:40 OCONNOR ROAD
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450
Practice Address - Country:US
Practice Address - Phone:585-383-6648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4476-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist