Provider Demographics
NPI:1841580784
Name:KAMPRATH-GIBAT OCCUPATIONAL THERAPY SERVICES, PC
Entity Type:Organization
Organization Name:KAMPRATH-GIBAT OCCUPATIONAL THERAPY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:KAMPRATH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:516-205-7994
Mailing Address - Street 1:56 FARRELL ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 FARRELL ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2619
Practice Address - Country:US
Practice Address - Phone:516-205-7994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency