Provider Demographics
NPI:1790336592
Name:SENSORY PLAYHOUSE OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:SENSORY PLAYHOUSE OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:VENISE
Authorized Official - Last Name:JEAN-CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-262-3449
Mailing Address - Street 1:5 LESTER AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-5912
Mailing Address - Country:US
Mailing Address - Phone:347-262-3449
Mailing Address - Fax:
Practice Address - Street 1:5 LESTER AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-5912
Practice Address - Country:US
Practice Address - Phone:347-262-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty