Provider Demographics
NPI:1790259513
Name:THERAPY CARE OT PC
Entity Type:Organization
Organization Name:THERAPY CARE OT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:718-353-7403
Mailing Address - Street 1:15814 NORTHERN BLVD STE UL3
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1600
Mailing Address - Country:US
Mailing Address - Phone:718-353-7403
Mailing Address - Fax:718-353-7404
Practice Address - Street 1:15814 NORTHERN BLVD STE UL3
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1600
Practice Address - Country:US
Practice Address - Phone:718-353-7403
Practice Address - Fax:718-353-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNONEMedicaid