Provider Demographics
NPI:1932428604
Name:CALLAN, PATRICIA S (OTR)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:S
Last Name:CALLAN
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 1:750 MAIDEN LN
Mailing Address - Street 2:GREECE CENTRAL SCHOOL DISTRICT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1230
Mailing Address - Country:US
Mailing Address - Phone:585-966-4746
Mailing Address - Fax:
Practice Address - Street 1:2089 MAIDEN LN
Practice Address - Street 2:AUTUMN LANE SCHOOL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1246
Practice Address - Country:US
Practice Address - Phone:585-966-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010201-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist