Provider Demographics
NPI:1801360839
Name:THRIVE PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:THRIVE PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:THRIVE PHYSICAL AND OCCUPATIONAL THERAPY, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-589-8242
Mailing Address - Street 1:267 EDGECOMBE AVE APT 2L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-3003
Mailing Address - Country:US
Mailing Address - Phone:917-589-8242
Mailing Address - Fax:646-513-2749
Practice Address - Street 1:267 EDGECOMBE AVE APT 2L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-3003
Practice Address - Country:US
Practice Address - Phone:917-589-8242
Practice Address - Fax:646-513-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-12
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty