Provider Demographics
NPI:1013208081
Name:MADGE DARGAN OT JANET KRZEMIENSKI OT PLLC
Entity Type:Organization
Organization Name:MADGE DARGAN OT JANET KRZEMIENSKI OT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MADGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:212-371-2996
Mailing Address - Street 1:300 E 57TH ST
Mailing Address - Street 2:1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2928
Mailing Address - Country:US
Mailing Address - Phone:212-371-2996
Mailing Address - Fax:212-980-1699
Practice Address - Street 1:300 E 57TH ST
Practice Address - Street 2:1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2928
Practice Address - Country:US
Practice Address - Phone:212-371-2996
Practice Address - Fax:212-980-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100050884Medicare UPIN