Provider Demographics
NPI:1063820298
Name:UBP OCCUPATIONAL THERAPY SERVICE PC
Entity Type:Organization
Organization Name:UBP OCCUPATIONAL THERAPY SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:UNICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRY BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:516-830-0162
Mailing Address - Street 1:1333 E ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3826
Mailing Address - Country:US
Mailing Address - Phone:516-830-0162
Mailing Address - Fax:
Practice Address - Street 1:1333 E ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3826
Practice Address - Country:US
Practice Address - Phone:516-830-0162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004413-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty