Provider Demographics
NPI:1740954544
Name:SDK PHYSICAL AND OCCUPATIONAL THERAPY, PLLC
Entity type:Organization
Organization Name:SDK PHYSICAL AND OCCUPATIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / OT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DESSI
Authorized Official - Last Name:KILEY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:917-273-8225
Mailing Address - Street 1:233 STAMFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-8202
Mailing Address - Country:US
Mailing Address - Phone:917-273-8225
Mailing Address - Fax:212-421-1750
Practice Address - Street 1:119 W 57TH ST STE 212
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2302
Practice Address - Country:US
Practice Address - Phone:212-421-5505
Practice Address - Fax:212-421-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty