Provider Demographics
NPI:1194390146
Name:WESTCHESTER MYOFUNCTIONAL SPECIALTIES
Entity Type:Organization
Organization Name:WESTCHESTER MYOFUNCTIONAL SPECIALTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MYOFUNCTIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-439-7837
Mailing Address - Street 1:774 WHITE PLAINS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5030
Mailing Address - Country:US
Mailing Address - Phone:914-348-3486
Mailing Address - Fax:
Practice Address - Street 1:774 WHITE PLAINS RD STE 250
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5030
Practice Address - Country:US
Practice Address - Phone:914-348-3486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH STAFFING SOLUTION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No125K00000XDental ProvidersAdvanced Practice Dental TherapistGroup - Multi-Specialty