Provider Demographics
NPI:1801379300
Name:COMPLETE OT AND OTA SERVICES PLLC
Entity Type:Organization
Organization Name:COMPLETE OT AND OTA SERVICES PLLC
Other - Org Name:COMPLETE OCCUPATIONAL THERAPY AND OCCUPATIONAL THERAPY SERVICES, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OTR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLUNE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:516-330-2912
Mailing Address - Street 1:2545 HEMPSTEAD TPKE STE LL4
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2143
Mailing Address - Country:US
Mailing Address - Phone:516-330-2912
Mailing Address - Fax:
Practice Address - Street 1:2545 HEMPSTEAD TPKE STE LL4
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2143
Practice Address - Country:US
Practice Address - Phone:516-330-2912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty