Organization
PEDIATRIC THERAPEUTICS-PT,OT,SLP&CSW,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARYBETH DEJOHN PT (EXECUTIVE DIRECTOR)
(716) 362-0020
Entity
Organization
Contact information
Practice address
90 PEARL ST, BUFFALO, NY 14202-4106
(716) 362-0020
(716) 362-0022
Mailing address
90 PEARL ST, BUFFALO, NY 14202-4106
(716) 362-0020
(716) 362-0022
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
4752568
NY
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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