Provider Demographics
NPI:1629381462
Name:THE MAGICAL SLOPE, O.T., P.T., PLLC
Entity Type:Organization
Organization Name:THE MAGICAL SLOPE, O.T., P.T., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAING
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:917-579-0875
Mailing Address - Street 1:320 2ND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-8504
Mailing Address - Country:US
Mailing Address - Phone:917-579-0875
Mailing Address - Fax:
Practice Address - Street 1:320 2ND ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-8504
Practice Address - Country:US
Practice Address - Phone:917-579-0875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities