Provider Demographics
NPI:1205110327
Name:OCCUPATIONAL THERAPY AND SOCIAL WORK ASSOCIATES, PLLC
Entity type:Organization
Organization Name:OCCUPATIONAL THERAPY AND SOCIAL WORK ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:212-288-1450
Mailing Address - Street 1:353 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1313
Mailing Address - Country:US
Mailing Address - Phone:212-288-1450
Mailing Address - Fax:
Practice Address - Street 1:353 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1313
Practice Address - Country:US
Practice Address - Phone:212-288-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031254-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services