Provider Demographics
NPI:1730651837
Name:FORWARD FUNCTION OCCUPATIONAL THERAPY AND PHYSICAL THERAPY P.L.L.C.
Entity Type:Organization
Organization Name:FORWARD FUNCTION OCCUPATIONAL THERAPY AND PHYSICAL THERAPY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:TOBIAS
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:631-275-8288
Mailing Address - Street 1:6633 YELLOWSTONE BLVD APT 3G
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2503
Mailing Address - Country:US
Mailing Address - Phone:631-275-8288
Mailing Address - Fax:631-201-3377
Practice Address - Street 1:6633 YELLOWSTONE BLVD APT 3G
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2503
Practice Address - Country:US
Practice Address - Phone:631-275-8288
Practice Address - Fax:631-201-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-30
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty