Provider Demographics
NPI:1063648954
Name:THE SENSORY CENTER FOR OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:THE SENSORY CENTER FOR OCCUPATIONAL THERAPY
Other - Org Name:THE SENSORY CENTER FOR OCCUPATIONAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:631-998-0433
Mailing Address - Street 1:26 SEA GATE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11977-1121
Mailing Address - Country:US
Mailing Address - Phone:631-998-0433
Mailing Address - Fax:631-998-0433
Practice Address - Street 1:26 SEA GATE AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11977-1121
Practice Address - Country:US
Practice Address - Phone:631-998-0433
Practice Address - Fax:631-998-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003744261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities