Individual
MR. EDWARD JOSEPH O'MALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
333 CHESTNUT ST, LIBERTY, NY 12754-1402
(845) 292-6307
(845) 292-6307
Mailing address
333 CHESTNUT ST, LIBERTY, NY 12754-1402
(845) 292-6307
(845) 292-6307
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
006150-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006150-1
NYS DEPT OF EDUCATION, OFFICE OF THE PROFESSIONS
NY
01
—
3887
DEPARTMENT OF HEALTH - NYS EARLY INTERVENTION PROGRAM
NY
Enumeration date
06/17/2009
Last updated
06/20/2009
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