Provider Demographics
NPI:1063167427
Name:HAND & REHABILITATION SPECIALISTS OT, PT, SLP, PLLC
Entity type:Organization
Organization Name:HAND & REHABILITATION SPECIALISTS OT, PT, SLP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L CHT
Authorized Official - Phone:716-631-5224
Mailing Address - Street 1:5144 SHERIDAN DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4653
Mailing Address - Country:US
Mailing Address - Phone:716-631-5224
Mailing Address - Fax:716-631-5626
Practice Address - Street 1:4535 SOUTHWESTERN BLVD STE 208
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1861
Practice Address - Country:US
Practice Address - Phone:716-631-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty