Provider Demographics
NPI:1831418359
Name:PEDIATRIC PHYSICAL AND OCCUPATIONAL THERAPY OF HUDSON VALLEY, PLLC
Entity type:Organization
Organization Name:PEDIATRIC PHYSICAL AND OCCUPATIONAL THERAPY OF HUDSON VALLEY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-362-7787
Mailing Address - Street 1:160 E ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2918
Mailing Address - Country:US
Mailing Address - Phone:845-362-7877
Mailing Address - Fax:845-362-7787
Practice Address - Street 1:160 E ROUTE 59
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2918
Practice Address - Country:US
Practice Address - Phone:845-362-7877
Practice Address - Fax:845-362-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009738-1225XP0200X
261QP2000X
NY010962-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty