Provider Demographics
NPI:1912118555
Name:ADVANCED HAND & OCCUPATIONAL THERAPY, PC
Entity Type:Organization
Organization Name:ADVANCED HAND & OCCUPATIONAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARACENO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL, CHT
Authorized Official - Phone:1718-698-9800
Mailing Address - Street 1:2372 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6607
Mailing Address - Country:US
Mailing Address - Phone:171-869-8980
Mailing Address - Fax:
Practice Address - Street 1:2372 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6607
Practice Address - Country:US
Practice Address - Phone:171-869-8980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090981332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5779880001Medicare NSC
NYQRW501Medicare PIN