Provider Demographics
NPI:1891211660
Name:VIDYA PINGALE LLC
Entity Type:Organization
Organization Name:VIDYA PINGALE LLC
Other - Org Name:THE THERAPY WORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/ OT
Authorized Official - Prefix:
Authorized Official - First Name:VIDYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINGALE
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR
Authorized Official - Phone:973-534-3474
Mailing Address - Street 1:123 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1003
Mailing Address - Country:US
Mailing Address - Phone:973-534-3474
Mailing Address - Fax:
Practice Address - Street 1:300 KNICKERBOCKER RD STE 3600
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-1349
Practice Address - Country:US
Practice Address - Phone:973-534-3474
Practice Address - Fax:973-534-3474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00255200225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty