Provider Demographics
NPI:1609237668
Name:A.B.L.E. OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:A.B.L.E. OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATRECANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-428-0963
Mailing Address - Street 1:322 LATHROP AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2532
Mailing Address - Country:US
Mailing Address - Phone:917-428-0963
Mailing Address - Fax:718-448-1053
Practice Address - Street 1:322 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2532
Practice Address - Country:US
Practice Address - Phone:917-428-0963
Practice Address - Fax:718-448-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006354-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty