Provider Demographics
NPI:1003139791
Name:NEIGHBORHOOD PHYSICAL & OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:NEIGHBORHOOD PHYSICAL & OCCUPATIONAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:R
Authorized Official - Last Name:DURING
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:212-348-0610
Mailing Address - Street 1:2226 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-2307
Mailing Address - Country:US
Mailing Address - Phone:212-348-0610
Mailing Address - Fax:
Practice Address - Street 1:2226 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2307
Practice Address - Country:US
Practice Address - Phone:212-348-0610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030543-1305R00000X
NY013570-1305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization