Provider Demographics
NPI:1487807459
Name:BACHMAN, MAIDA FAYE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MAIDA
Middle Name:FAYE
Last Name:BACHMAN
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 1:5371 STATE ROUTE 364
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NY
Mailing Address - Zip Code:14507-9701
Mailing Address - Country:US
Mailing Address - Phone:585-455-0410
Mailing Address - Fax:585-554-5296
Practice Address - Street 1:5371 STATE ROUTE 364
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NY
Practice Address - Zip Code:14507-9701
Practice Address - Country:US
Practice Address - Phone:585-455-0410
Practice Address - Fax:585-554-5296
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005113-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist