Provider Demographics
NPI:1851564397
Name:STEPHANIE DESSI KILEY OCCUPATIONAL THERAPY PC
Entity Type:Organization
Organization Name:STEPHANIE DESSI KILEY OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DESSI
Authorized Official - Last Name:KILEY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:917-273-8225
Mailing Address - Street 1:119 W 57TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2302
Mailing Address - Country:US
Mailing Address - Phone:212-421-5505
Mailing Address - Fax:212-421-1750
Practice Address - Street 1:119 W 57TH ST STE 212
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-421-5505
Practice Address - Fax:212-421-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11319-1261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation