Provider Demographics
NPI:1245753508
Name:FIT TO FUNCTION OCCUPATIONAL THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:FIT TO FUNCTION OCCUPATIONAL THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANGEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:631-355-0882
Mailing Address - Street 1:11 CAPRI CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6400
Mailing Address - Country:US
Mailing Address - Phone:631-355-0882
Mailing Address - Fax:866-850-4553
Practice Address - Street 1:256 W OLD COUNTRY RD UNIT A
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-4034
Practice Address - Country:US
Practice Address - Phone:631-355-0882
Practice Address - Fax:866-850-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115630OtherNYS DEPT OF EDUCATION - OFFICE OF THE PROFESSIONS