Provider Demographics
NPI:1578036166
Name:ZAYKOWSKI, AMI TRICARICO (OTR/L)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:TRICARICO
Last Name:ZAYKOWSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-2012
Mailing Address - Country:US
Mailing Address - Phone:570-562-2102
Mailing Address - Fax:
Practice Address - Street 1:500 W HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:PA
Practice Address - Zip Code:18517-2012
Practice Address - Country:US
Practice Address - Phone:570-562-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003179L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist