Individual
SHANE HAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
27 PAVONIA ST, BUFFALO, NY 14207-2318
(585) 236-6188
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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