Basic Information
Provider Information
NPI: 1275080517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EMIGH
FirstName: OLIVIA
MiddleName: FRANCES W.
NamePrefix:  
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8520 GREEN RD
Address2:  
City: DANSVILLE
State: NY
PostalCode: 144379140
CountryCode: US
TelephoneNumber: 5857609444
FaxNumber:  
Practice Location
Address1: 580 FISHERS STATION DR
Address2: SUITE 130
City: VICTOR
State: NY
PostalCode: 145649734
CountryCode: US
TelephoneNumber: 5859247207
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/03/2016
LastUpdateDate: 09/03/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X020797-1NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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