Provider Demographics
NPI:1376139790
Name:PENINSULA HAND THERAPY PLLC
Entity Type:Organization
Organization Name:PENINSULA HAND THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BATE
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT
Authorized Official - Phone:917-881-0963
Mailing Address - Street 1:101 DEMOCRACY ST APT 312
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-5672
Mailing Address - Country:US
Mailing Address - Phone:917-881-0963
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 905
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4218
Practice Address - Country:US
Practice Address - Phone:757-916-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty