Provider Demographics
NPI:1023164282
Name:ADVANTAGE PHYSICAL & OCCUPATIONAL THERAPY PLLC
Entity type:Organization
Organization Name:ADVANTAGE PHYSICAL & OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:STOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-960-2006
Mailing Address - Street 1:534 W 112TH ST # 872
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9721
Mailing Address - Country:US
Mailing Address - Phone:917-716-5392
Mailing Address - Fax:212-820-9773
Practice Address - Street 1:534 W 112TH ST # 872
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-9721
Practice Address - Country:US
Practice Address - Phone:917-716-5392
Practice Address - Fax:212-820-9773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN81820OtherHEALTH NET ID
1125744OtherEMBLEM
NYP2967582OtherOXFORD HEALTH PLANS ID