# PEDIATRIC THERAPEUTICS-PT,OT,SLP&CSW,PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265697882
- **Authorized official:** MS. MARYBETH DEJOHN PT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (716) 362-0020

## Contact information

- **Practice address:** 90 PEARL ST, BUFFALO, NY 14202-4106
- **Practice address phone:** (716) 362-0020
- **Practice address fax:** (716) 362-0022
- **Mailing address:** 90 PEARL ST, BUFFALO, NY 14202-4106
- **Mailing address phone:** (716) 362-0020
- **Mailing address fax:** (716) 362-0022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 4752568 | NY | Yes |

## Other

- **Enumeration date:** 07/23/2008
- **Last updated:** 07/23/2008