Individual
MRS. LEAH ANN BIDTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2565 ELMWOOD AVE, KENMORE, NY 14217-1939
(716) 871-9883
Mailing address
142 BRIARCLIFF RD, CHEEKTOWAGA, NY 14225-1060
(716) 200-0626
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
010133-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010133-1
STATE LICENSE NUMBER
NY
Enumeration date
11/25/2006
Last updated
07/08/2007
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