Provider Demographics
NPI:1063190163
Name:ALTIERI, ISABELLA M (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ISABELLA
Middle Name:M
Last Name:ALTIERI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 HOERNER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14211-2707
Mailing Address - Country:US
Mailing Address - Phone:585-857-7007
Mailing Address - Fax:
Practice Address - Street 1:1780 WEHRLE DR STE 110
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7000
Practice Address - Country:US
Practice Address - Phone:716-362-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028076-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist