Individual
MADISON HEIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
83 DIANE DR, BUFFALO, NY 14225-3601
(716) 548-2182
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
029321
NY
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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