Individual
NICOLE CIANCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
573 AUBURN AVE APT 4, BUFFALO, NY 14222-1350
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
P07090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P07090
LIMITED PERMIT
NY
Enumeration date
07/20/2017
Last updated
06/16/2018
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