Provider Demographics
NPI:1144501735
Name:CLAUS, AMY SUZANNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUZANNE
Last Name:CLAUS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:SUZANNE
Other - Last Name:WOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1136 S. SHORE ROAD
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12835
Mailing Address - Country:US
Mailing Address - Phone:518-312-0887
Mailing Address - Fax:
Practice Address - Street 1:WSWHE BOCES
Practice Address - Street 2:15 HENNIG ROAD
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-581-3605
Practice Address - Fax:518-581-3844
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NY005433-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY776Medicaid
NY1144501735Medicaid