Provider Demographics
NPI:1437522786
Name:VALLEY STREAM OCCUPATIONAL THERAPY P.C
Entity Type:Organization
Organization Name:VALLEY STREAM OCCUPATIONAL THERAPY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANATOLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEKTOR
Authorized Official - Suffix:
Authorized Official - Credentials:OCCUPATIONAL THERAPY
Authorized Official - Phone:718-314-7440
Mailing Address - Street 1:301 ORIENTAL BLVD
Mailing Address - Street 2:APT 1F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4149
Mailing Address - Country:US
Mailing Address - Phone:718-314-7440
Mailing Address - Fax:718-334-0057
Practice Address - Street 1:301 ORIENTAL BLVD
Practice Address - Street 2:APT 1F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4149
Practice Address - Country:US
Practice Address - Phone:718-314-7440
Practice Address - Fax:718-334-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253382158251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health