Basic Information
| Provider Information | |||||||||
| NPI: | 1760765895 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | AYERS | ||||||||
| FirstName: | DIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 E WASHINGTON ST | ||||||||
| Address2: | APT. 202 | ||||||||
| City: | BATH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148101341 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8455 COUNTY ROUTE 125 | ||||||||
| Address2: | BOCES OFFICE | ||||||||
| City: | CAMPBELL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148219518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077393581 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2011 | ||||||||
| LastUpdateDate: | 09/28/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 006786-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.