Provider Demographics
NPI:1336508258
Name:ALL ISLAND OCCUPATIONAL THERAPY, PC
Entity Type:Organization
Organization Name:ALL ISLAND OCCUPATIONAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-492-4227
Mailing Address - Street 1:3099 CONEY ISLAND AVE
Mailing Address - Street 2:1ST FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6305
Mailing Address - Country:US
Mailing Address - Phone:718-492-4227
Mailing Address - Fax:718-492-4229
Practice Address - Street 1:3099 CONEY ISLAND AVE
Practice Address - Street 2:1ST FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6305
Practice Address - Country:US
Practice Address - Phone:718-492-4227
Practice Address - Fax:718-492-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty