Provider Demographics
NPI:1164643060
Name:FAYE GRAND, OTR CHT PC
Entity Type:Organization
Organization Name:FAYE GRAND, OTR CHT PC
Other - Org Name:HAND THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:MARCIA
Authorized Official - Last Name:GRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:718-424-7856
Mailing Address - Street 1:9131 QUEENS BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5555
Mailing Address - Country:US
Mailing Address - Phone:718-424-7856
Mailing Address - Fax:
Practice Address - Street 1:9131 QUEENS BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5555
Practice Address - Country:US
Practice Address - Phone:718-424-7856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001704225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06885GMedicare PIN
NY4610960002Medicare NSC