Provider Demographics
NPI:1831469626
Name:KIDAPILLAR OCCUPATIONAL THERAPY, PC
Entity Type:Organization
Organization Name:KIDAPILLAR OCCUPATIONAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSANG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, OTR/L
Authorized Official - Phone:718-813-4770
Mailing Address - Street 1:258-05 PEMBROKE AVE.,
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020
Mailing Address - Country:US
Mailing Address - Phone:718-813-4770
Mailing Address - Fax:516-482-1257
Practice Address - Street 1:149-23 SANFORD AVE.,
Practice Address - Street 2:SUITE A1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-813-4770
Practice Address - Fax:516-482-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005017225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty