Provider Demographics
NPI:1598482820
Name:PADILLA, FELIX BRIAN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:BRIAN
Last Name:PADILLA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HAVEMEYER ST APT 21A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8401
Mailing Address - Country:US
Mailing Address - Phone:917-270-6496
Mailing Address - Fax:
Practice Address - Street 1:255 HAVEMEYER ST APT 21A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-8401
Practice Address - Country:US
Practice Address - Phone:917-270-6496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027398-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist