Provider Demographics
NPI:1619622461
Name:COMPREHENSIVE OT, PT, SLP & ADULT HEALTH NP SERVICES, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE OT, PT, SLP & ADULT HEALTH NP SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERGSON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS-JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:845-641-9413
Mailing Address - Street 1:5020 ROUTE 9W SUITE 16
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-7919
Mailing Address - Country:US
Mailing Address - Phone:845-641-9413
Mailing Address - Fax:
Practice Address - Street 1:5020 ROUTE 9W SUITE 16
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-7919
Practice Address - Country:US
Practice Address - Phone:845-641-9413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty