Provider Demographics
NPI:1992860076
Name:SOUTH SHORE HAND THERAPY AND OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:SOUTH SHORE HAND THERAPY AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:DBA SOUTH SHORE HAND THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:516-868-5302
Mailing Address - Street 1:2384 LINDENMERE DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4312
Mailing Address - Country:US
Mailing Address - Phone:516-868-5302
Mailing Address - Fax:516-546-7681
Practice Address - Street 1:2108 MERRICK MALL
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3626
Practice Address - Country:US
Practice Address - Phone:516-868-5302
Practice Address - Fax:516-546-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002788-1225XH1200X, 225XN1300X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty