Provider Demographics
NPI:1942624275
Name:MADISON OCCUPATIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:MADISON OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SCHONDELD
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:646-412-5666
Mailing Address - Street 1:8829 FORT HAMILTON PKWY
Mailing Address - Street 2:SUITE D01
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6049
Mailing Address - Country:US
Mailing Address - Phone:347-459-0616
Mailing Address - Fax:
Practice Address - Street 1:8829 FORT HAMILTON PKWY
Practice Address - Street 2:SUITE D01
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6049
Practice Address - Country:US
Practice Address - Phone:347-459-0616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty