Provider Demographics
NPI:1982692646
Name:ALESSANDRINI, RAYMOND A (OT)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:A
Last Name:ALESSANDRINI
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4515
Mailing Address - Country:US
Mailing Address - Phone:315-790-5392
Mailing Address - Fax:315-839-5587
Practice Address - Street 1:505 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4515
Practice Address - Country:US
Practice Address - Phone:315-790-5392
Practice Address - Fax:315-839-5587
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007433225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01641698Medicaid
RA7950Medicare ID - Type Unspecified