Provider Demographics
NPI:1275953317
Name:APPLE BLOSSOM OCCUPATIONAL THERAPY SERVICES PLLC.
Entity Type:Organization
Organization Name:APPLE BLOSSOM OCCUPATIONAL THERAPY SERVICES PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VAISHALI
Authorized Official - Middle Name:PRAKASH
Authorized Official - Last Name:KHANDARE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:347-210-2963
Mailing Address - Street 1:210 E 86TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3003
Mailing Address - Country:US
Mailing Address - Phone:347-210-2963
Mailing Address - Fax:917-508-4856
Practice Address - Street 1:139 E 33RD ST
Practice Address - Street 2:APT 15D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5338
Practice Address - Country:US
Practice Address - Phone:347-210-2963
Practice Address - Fax:917-508-4856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010190261QD1600X, 261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)