Organization
DIVERSIFIED SERVICES FOR OCCUPATIONAL THERAPY, PHYSICAL THER
Active
Other names
Diversified Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALVATORE GRUTTADAURIA AU.D. (PRESIDENT-CEO)
(716) 871-9883
Entity
Organization
Contact information
Practice address
2900 DELAWARE AVE, KENMORE, NY 14217-2309
(716) 871-9883
(716) 871-9887
Mailing address
2900 DELAWARE AVE, KENMORE, NY 14217-2309
(716) 871-9883
(716) 871-9887
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
001149
NY
235Z00000X
Speech-Language Pathologist
000846
NY
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01806404
—
NY
05
—
02667421
—
NY
05
—
02671290
—
NY
05
—
02690875
—
NY
05
—
02690884
—
NY
05
—
02700365
—
NY
Enumeration date
07/09/2006
Last updated
05/04/2020
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