Provider Demographics
NPI:1841813805
Name:ENGAGE PT OT AND SLP
Entity type:Organization
Organization Name:ENGAGE PT OT AND SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-868-1114
Mailing Address - Street 1:3175 E GENESEE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1613
Mailing Address - Country:US
Mailing Address - Phone:716-868-1114
Mailing Address - Fax:833-262-8905
Practice Address - Street 1:3175 E GENESEE ST STE 5
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1613
Practice Address - Country:US
Practice Address - Phone:716-868-1114
Practice Address - Fax:833-262-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty