Provider Demographics
NPI:1679841647
Name:NY OCCUPATIONAL THERAPY, P.C.
Entity Type:Organization
Organization Name:NY OCCUPATIONAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:718-968-5524
Mailing Address - Street 1:298 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1235
Mailing Address - Country:US
Mailing Address - Phone:718-968-5524
Mailing Address - Fax:
Practice Address - Street 1:298 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1235
Practice Address - Country:US
Practice Address - Phone:718-968-5524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013497-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty