National Provider Identifier

Staci Pegelow

Staci Pegelow is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Randolph, NY and a listed phone number of (716) 983-8985.

NPI 1821425125Randolph, NYOccupational Therapy Assistant

Profile Overview

NPI
1821425125
Provider Type
Individual
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
October 01, 2013
Last Updated
October 01, 2013

Practice Location

  • 73 Coldspring St
  • Randolph, NY 14772-9664

Phone: (716) 983-8985

Specialties

  • Occupational Therapy Assistant (224Z00000X)
Full Record
NPI
1821425125
Entity Type
Individual
Last Name
Pegelow
First Name
Staci
Mailing Street Address
73 Coldspring St
Mailing City
Randolph
Mailing State
NY
Mailing ZIP Code
14772-9664
Mailing Country
US
Practice Street Address
73 Coldspring St
Practice City
Randolph
Practice State
NY
Practice ZIP Code
14772-9664
Practice Country
US
Practice Phone
(716) 983-8985
Enumeration Date
October 01, 2013
Last Updated
October 01, 2013
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapy Assistant (224Z00000X)