Provider Demographics
NPI:1619186376
Name:HAND&OCCUPATIONAL THERAPY,PC
Entity Type:Organization
Organization Name:HAND&OCCUPATIONAL THERAPY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:631-728-7875
Mailing Address - Street 1:188 W MONTAUK HWY
Mailing Address - Street 2:SUITE E6
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2363
Mailing Address - Country:US
Mailing Address - Phone:631-728-7875
Mailing Address - Fax:631-728-8204
Practice Address - Street 1:188 W MONTAUK HWY
Practice Address - Street 2:SUITE E6
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2363
Practice Address - Country:US
Practice Address - Phone:631-728-7875
Practice Address - Fax:631-728-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005924-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY210401OtherETNA
NY93542OtherVYTRA
NY01949733Medicaid
NY99710OtherSIGNA
NYAZ00901OtherMDNY
NYP1272767OtherOXFORD
NY201388OtherHIP
NY941863OtherACN
NYQ90571Medicare ID - Type UnspecifiedMEDICARE
NY1263270001Medicare NSC