National Provider Identifier
Mary Carolyn Divita, OTR
Mary Carolyn Divita, OTR is listed in the NPPES registry with a primary specialty of Specialist in West Seneca, NY and a listed phone number of (716) 821-7182.
Profile Overview
- NPI
- 1316220486
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- September 24, 2011
- Last Updated
- September 24, 2011
Practice Location
- 355 Harlem RD
- West Seneca, NY 14224-1825
Phone: (716) 821-7182
Mailing Address
- 103 Andover Ln
- Williamsville, NY 14221-3365
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1316220486
- Entity Type
- Individual
- Last Name
- Divita
- First Name
- Mary
- Middle Name
- Carolyn
- Name Prefix
- Mrs.
- Credential
- OTR
- Mailing Street Address
- 103 Andover Ln
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-3365
- Mailing Country
- US
- Mailing Phone
- (716) 634-6702
- Practice Street Address
- 355 Harlem RD
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224-1825
- Practice Country
- US
- Practice Phone
- (716) 821-7182
- Enumeration Date
- September 24, 2011
- Last Updated
- September 24, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)
- Other Identifiers
- 0037741 (NY, Nys License)