Provider Demographics
NPI:1427412758
Name:LETTERESE OCCUPATIONAL THERAPY PC
Entity Type:Organization
Organization Name:LETTERESE OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LETTERESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-893-2459
Mailing Address - Street 1:35 DAVENPORT AVE
Mailing Address - Street 2:APARTMENT 3G
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3449
Mailing Address - Country:US
Mailing Address - Phone:845-893-2459
Mailing Address - Fax:
Practice Address - Street 1:35 DAVENPORT AVE
Practice Address - Street 2:APARTMENT 3G
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3449
Practice Address - Country:US
Practice Address - Phone:845-893-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019471-1314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility