Provider Demographics
NPI:1649209750
Name:ADVANCED HAND & OCCUPATIONAL THERAPY, PC
Entity Type:Organization
Organization Name:ADVANCED HAND & OCCUPATIONAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARACENO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:718-698-9800
Mailing Address - Street 1:6917 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1119
Mailing Address - Country:US
Mailing Address - Phone:718-779-8559
Mailing Address - Fax:
Practice Address - Street 1:2372 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6607
Practice Address - Country:US
Practice Address - Phone:718-698-9800
Practice Address - Fax:718-698-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090981225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7070452OtherAETNA
NY009098OtherHIP
NY1699738OtherGHI
NYG2739397OtherOXFORD
NY2002047OtherUNITED HEALTHCARE
NYQS7731OtherBLUE CROSS BLUE SHIELD
NY2002047OtherUNITED HEALTHCARE
NYG2739397OtherOXFORD