| Able 2 Enhancing Potential | |
|
1118 Charles Street Elmira NY 14902-1554 | |
| (607) 734-7107 | |
| (607) 734-7334 |
| Full Name | Able 2 Enhancing Potential |
|---|---|
| Speciality | Clinic/Center |
| Location | 1118 Charles Street, Elmira, New York |
| Authorized Official Name and Position | Mark Stephen Peters (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6077347101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Able 2 Enhancing Potential Po Box 1554 Elmira NY 14902-1554 Ph: (607) 734-7107 | Able 2 Enhancing Potential 1118 Charles Street Elmira NY 14902-1554 Ph: (607) 734-7107 |
| NPI Number | 1841308392 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 01/18/2013 |
| Medicare PECOS PAC ID | 2365466927 |
|---|---|
| Medicare Enrollment ID | O20060123000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841308392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 0701202R (New York) | Primary |
| Provider Name | Brian P Busch |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831430859 PECOS PAC ID: 1759630973 Enrollment ID: I20180822000486 |
| Provider Name | Wendy J Bevan |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1174864292 PECOS PAC ID: 4688925233 Enrollment ID: I20180921000316 |
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