Provider Demographics
NPI:1740673508
Name:EXCEL THERAPY CORP
Entity type:Organization
Organization Name:EXCEL THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:YANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L
Authorized Official - Phone:646-322-7427
Mailing Address - Street 1:140 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4441
Mailing Address - Country:US
Mailing Address - Phone:646-322-7427
Mailing Address - Fax:
Practice Address - Street 1:140 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4441
Practice Address - Country:US
Practice Address - Phone:646-322-7427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017788252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency