Basic Information
| Provider Information | |||||||||
| NPI: | 1710158258 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTON PAXXON PT, OT & SLP, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 SULLIVAN TRL | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180407958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009449782 | ||||||||
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| Practice Location | |||||||||
| Address1: | 27 WOODVALE RD | ||||||||
| Address2: | THE LANDING @ QUEENSBURY | ||||||||
| City: | QUEENSBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128041785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187935556 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2008 | ||||||||
| LastUpdateDate: | 03/12/2008 | ||||||||
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| AuthorizedOfficialLastName: | ORLANDI | ||||||||
| AuthorizedOfficialFirstName: | TOM | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6109912034 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.