Provider Demographics
NPI:1629364724
Name:PLAYWORKS OT PT PLLC
Entity Type:Organization
Organization Name:PLAYWORKS OT PT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:347-453-4508
Mailing Address - Street 1:6510 99TH ST
Mailing Address - Street 2:LL1
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3569
Mailing Address - Country:US
Mailing Address - Phone:718-606-1818
Mailing Address - Fax:718-606-9436
Practice Address - Street 1:6510 99TH ST
Practice Address - Street 2:LL1
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3569
Practice Address - Country:US
Practice Address - Phone:718-606-1818
Practice Address - Fax:718-606-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0260871252Y00000X
NY0127191252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency