Provider Demographics
NPI:1982749677
Name:LIHT OCCUPATIONAL THERAPY PC
Entity Type:Organization
Organization Name:LIHT OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEFEO
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:516-505-2200
Mailing Address - Street 1:300 HEMPSTEAD TPKE
Mailing Address - Street 2:STE 3
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1450
Mailing Address - Country:US
Mailing Address - Phone:516-505-2200
Mailing Address - Fax:516-505-5416
Practice Address - Street 1:300 HEMPSTEAD TPKE
Practice Address - Street 2:STE 3
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1450
Practice Address - Country:US
Practice Address - Phone:516-505-2200
Practice Address - Fax:516-505-5416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013321-1261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQTW961Medicare PIN