Provider Demographics
NPI:1952036121
Name:CONNECTED KIDS OT PLLC
Entity Type:Organization
Organization Name:CONNECTED KIDS OT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ITZKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-304-0371
Mailing Address - Street 1:11 DIKE DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1113
Mailing Address - Country:US
Mailing Address - Phone:845-304-0371
Mailing Address - Fax:
Practice Address - Street 1:11 DIKE DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1113
Practice Address - Country:US
Practice Address - Phone:845-304-0371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty