Provider Demographics
NPI:1902228620
Name:LITTLE WONDERS THERAPEUTIC SERVICES, OT, P.C.
Entity Type:Organization
Organization Name:LITTLE WONDERS THERAPEUTIC SERVICES, OT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:DUFIE
Authorized Official - Last Name:ONWUMERE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:917-592-9493
Mailing Address - Street 1:1055 ESPLANADE AVE
Mailing Address - Street 2:APT. 2A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1235
Mailing Address - Country:US
Mailing Address - Phone:917-592-9493
Mailing Address - Fax:
Practice Address - Street 1:1055 ESPLANADE AVE
Practice Address - Street 2:APT. 2A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1235
Practice Address - Country:US
Practice Address - Phone:917-592-9493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014368-1225X00000X, 225XF0002X, 225XN1300X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty