Provider Demographics
NPI:1326357880
Name:THERAPEUTIC CONSULTING SERVICE OT PC
Entity Type:Organization
Organization Name:THERAPEUTIC CONSULTING SERVICE OT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:646-302-6709
Mailing Address - Street 1:38 BYWAY DR
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-6205
Mailing Address - Country:US
Mailing Address - Phone:646-302-6709
Mailing Address - Fax:631-242-0446
Practice Address - Street 1:38 BYWAY DR
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-6205
Practice Address - Country:US
Practice Address - Phone:646-302-6709
Practice Address - Fax:631-242-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008188-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty