Provider Demographics
NPI:1083221915
Name:OCCUPATIONAL AND BEHAVIORAL THERAPIES
Entity Type:Organization
Organization Name:OCCUPATIONAL AND BEHAVIORAL THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAMIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANJI
Authorized Official - Suffix:
Authorized Official - Credentials:MSCOT
Authorized Official - Phone:716-725-1805
Mailing Address - Street 1:3333 N CALVERT ST STE 585
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6514
Mailing Address - Country:US
Mailing Address - Phone:716-725-1805
Mailing Address - Fax:
Practice Address - Street 1:3333 N CALVERT ST STE 585
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6514
Practice Address - Country:US
Practice Address - Phone:716-725-1805
Practice Address - Fax:855-655-5326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies