Provider Demographics
NPI:1619544079
Name:PRIME AT HOME OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:PRIME AT HOME OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VALMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-402-3719
Mailing Address - Street 1:27 OSSMAN DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2653
Mailing Address - Country:US
Mailing Address - Phone:646-402-3719
Mailing Address - Fax:
Practice Address - Street 1:27 OSSMAN DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2653
Practice Address - Country:US
Practice Address - Phone:646-402-3719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty