Provider Demographics
NPI:1003957135
Name:CHILDREN'S HEALTH AND THERAPEUTIC SERVICES PT,OT,SLP,PLLC
Entity Type:Organization
Organization Name:CHILDREN'S HEALTH AND THERAPEUTIC SERVICES PT,OT,SLP,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LODATO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:631-369-3694
Mailing Address - Street 1:1303 ROANOKE AVE
Mailing Address - Street 2:PO BOX 1327
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2748
Mailing Address - Country:US
Mailing Address - Phone:631-369-3694
Mailing Address - Fax:631-369-3694
Practice Address - Street 1:1303 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2748
Practice Address - Country:US
Practice Address - Phone:631-369-3694
Practice Address - Fax:631-369-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty