Provider Demographics
NPI:1255950689
Name:MOLLY RABINOWITZ DBA OTPLUS THERAPEUTICS
Entity type:Organization
Organization Name:MOLLY RABINOWITZ DBA OTPLUS THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTL
Authorized Official - Phone:347-400-2197
Mailing Address - Street 1:26 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5138
Mailing Address - Country:US
Mailing Address - Phone:347-400-2197
Mailing Address - Fax:
Practice Address - Street 1:26 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5138
Practice Address - Country:US
Practice Address - Phone:347-400-2197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation