Provider Demographics
NPI:1275083677
Name:CHIDREN OCCUPATIONAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:CHIDREN OCCUPATIONAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCIARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-797-3403
Mailing Address - Street 1:26 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3212
Mailing Address - Country:US
Mailing Address - Phone:617-797-3403
Mailing Address - Fax:
Practice Address - Street 1:26 GEORGE ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-3212
Practice Address - Country:US
Practice Address - Phone:617-797-3403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6964225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty