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NPI Code Detail

MEDICARE: ANTOINE FREDERIC VALCOURT OTR

MEDICARE: ANTOINE FREDERIC VALCOURT OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist116483TX

General Provider Information

NPI Number : 1558731737
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINE FREDERIC VALCOURT OTR
Provider Business Mailing Address
First Line : 212 OLD COUNTRY RD
Second Line :
City : DEER PARK
State : NY
Zip : 11729-1922
Country : US
Telephone Number : 806-290-1172
Fax Number : 631-938-0739
Provider Business Practice Location Address
First Line : 1842 E JERICHO TPKE UNIT P
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-5796
Country : US
Telephone Number : 631-486-7900
Fax Number : 631-938-0739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2015
Last Update Date : 11/30/2022

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