Provider Demographics
NPI:1083874101
Name:STAR THERAPY & SALES CORP
Entity Type:Organization
Organization Name:STAR THERAPY & SALES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PRUSZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:330-221-7634
Mailing Address - Street 1:8245 PECK RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-9772
Mailing Address - Country:US
Mailing Address - Phone:330-221-7634
Mailing Address - Fax:
Practice Address - Street 1:8245 PECK RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-9772
Practice Address - Country:US
Practice Address - Phone:330-221-7634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty