Provider Demographics
NPI:1568846087
Name:B&B REHABILITATION OT PC
Entity Type:Organization
Organization Name:B&B REHABILITATION OT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSEPENYUK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L,MS
Authorized Official - Phone:718-536-8445
Mailing Address - Street 1:120 OCEANA DR W
Mailing Address - Street 2:3F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6659
Mailing Address - Country:US
Mailing Address - Phone:718-536-8445
Mailing Address - Fax:718-615-2198
Practice Address - Street 1:120 OCEANA DR W
Practice Address - Street 2:3F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6659
Practice Address - Country:US
Practice Address - Phone:718-536-8445
Practice Address - Fax:718-615-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015922-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency