Provider Demographics
NPI:1346906336
Name:OT DYNAMICS SERVICES LLC
Entity Type:Organization
Organization Name:OT DYNAMICS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNELYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SARAEL
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:646-262-7407
Mailing Address - Street 1:1368 83RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3035
Mailing Address - Country:US
Mailing Address - Phone:646-262-7407
Mailing Address - Fax:718-232-4343
Practice Address - Street 1:1336 50TH STREET KIDS IN SHAPE THERAPY CENTER
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-435-6906
Practice Address - Fax:718-435-6908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No252Y00000XAgenciesEarly Intervention Provider Agency