Provider Demographics
NPI:1629148259
Name:ABILITY BEYOND DISABILITY
Entity Type:Organization
Organization Name:ABILITY BEYOND DISABILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P & C.A.F.O
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:I
Authorized Official - Last Name:PASQUALINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-775-4700
Mailing Address - Street 1:4 BERKSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1001
Mailing Address - Country:US
Mailing Address - Phone:203-775-4700
Mailing Address - Fax:203-775-5734
Practice Address - Street 1:480 BEDFORD ROAD
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514
Practice Address - Country:US
Practice Address - Phone:914-242-8720
Practice Address - Fax:914-242-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5946201R174400000X, 225100000X, 225XN1300X, 320900000X
5946201R320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01827967Medicaid
NYWWP031Medicare ID - Type UnspecifiedMCR PART B
NY01827967Medicaid