Provider Demographics
NPI:1467851980
Name:VITAL CARE NY OT PC
Entity Type:Organization
Organization Name:VITAL CARE NY OT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOBODYANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:718-781-8283
Mailing Address - Street 1:601 SURF AVE
Mailing Address - Street 2:STE 15-G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3450
Mailing Address - Country:US
Mailing Address - Phone:718-781-8283
Mailing Address - Fax:718-333-1398
Practice Address - Street 1:601 SURF AVE
Practice Address - Street 2:STE 15-G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3450
Practice Address - Country:US
Practice Address - Phone:718-781-8283
Practice Address - Fax:718-333-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty