Provider Demographics
NPI:1609088509
Name:FAYE GRAND, OTR L CHT
Entity Type:Organization
Organization Name:FAYE GRAND, OTR L CHT
Other - Org Name:HAND THERAPY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L CHT
Authorized Official - Phone:718-343-4263
Mailing Address - Street 1:26808 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1351
Mailing Address - Country:US
Mailing Address - Phone:718-343-4263
Mailing Address - Fax:718-347-0738
Practice Address - Street 1:366 N BROADWAY
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2025
Practice Address - Country:US
Practice Address - Phone:516-933-2515
Practice Address - Fax:516-933-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001704225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06885GMedicare PIN
NY4610960004Medicare NSC