Provider Demographics
NPI:1174199350
Name:URBANPLAY INNOVATIVE OT, PPLC
Entity Type:Organization
Organization Name:URBANPLAY INNOVATIVE OT, PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZIN
Authorized Official - Suffix:
Authorized Official - Credentials:OT/L, PMH-C
Authorized Official - Phone:585-305-5312
Mailing Address - Street 1:270 WILLOWBEND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4050
Mailing Address - Country:US
Mailing Address - Phone:585-305-5312
Mailing Address - Fax:
Practice Address - Street 1:270 WILLOWBEND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4050
Practice Address - Country:US
Practice Address - Phone:585-305-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty