Provider Demographics
NPI:1235432253
Name:STAR CARE OCCUPATIONAL THERAPY PC
Entity Type:Organization
Organization Name:STAR CARE OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:STARIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-908-1799
Mailing Address - Street 1:7016 PERRY TER
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1116
Mailing Address - Country:US
Mailing Address - Phone:718-908-1799
Mailing Address - Fax:718-833-0062
Practice Address - Street 1:7016 PERRY TER
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1116
Practice Address - Country:US
Practice Address - Phone:718-908-1799
Practice Address - Fax:718-833-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010813-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty