Provider Demographics
NPI: | 1881876407 |
---|---|
Name: | HANDSON OCCUPATIONAL THERAPRY |
Entity type: | Organization |
Organization Name: | HANDSON OCCUPATIONAL THERAPRY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DIMITRIOS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KOSTOPOULOS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-707-6970 |
Mailing Address - Street 1: | 3636 33RD ST |
Mailing Address - Street 2: | SUITE 403 |
Mailing Address - City: | ASTORIA |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11106-2329 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 708-707-6970 |
Mailing Address - Fax: | 718-732-2864 |
Practice Address - Street 1: | 39 E 78TH ST |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10075-0213 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-439-9303 |
Practice Address - Fax: | 212-744-4481 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-12-05 |
Last Update Date: | 2007-12-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 011820-1 | 174400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Single Specialty |