Provider Demographics
NPI:1811134943
Name:CHILD OT OF WESTCHESTER
Entity type:Organization
Organization Name:CHILD OT OF WESTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OT
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:NICASTRO-PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:914-722-6030
Mailing Address - Street 1:1075 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3242
Mailing Address - Country:US
Mailing Address - Phone:914-722-6030
Mailing Address - Fax:914-722-6037
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-722-6030
Practice Address - Fax:914-722-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64007240174400000X
NY014985-1235Z00000X
NY010538-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty