Provider Demographics
NPI:1316423619
Name:GRIMALDI, ALLISON JEAN (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JEAN
Last Name:GRIMALDI
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 1:30 HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2234
Mailing Address - Country:US
Mailing Address - Phone:716-631-5777
Mailing Address - Fax:716-631-9234
Practice Address - Street 1:30 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2234
Practice Address - Country:US
Practice Address - Phone:716-631-5777
Practice Address - Fax:716-631-9234
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist