Provider Demographics
NPI:1407393168
Name:JHC OT LLC
Entity Type:Organization
Organization Name:JHC OT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-563-1921
Mailing Address - Street 1:3226 UNION ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3197
Mailing Address - Country:US
Mailing Address - Phone:917-563-1921
Mailing Address - Fax:917-563-1905
Practice Address - Street 1:3226 UNION ST STE 1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3197
Practice Address - Country:US
Practice Address - Phone:917-563-1921
Practice Address - Fax:917-563-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NY014662-1273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes273Y00000XHospital UnitsRehabilitation Unit
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04956598Medicaid