Healthcare Provider Details
I. General information
NPI: 1962604637
Provider Name (Legal Business Name): HANDSON OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4401 FRANCIS LEWIS BLVD
BAYSIDE NY
11361-3002
US
IV. Provider business mailing address
3636 33RD ST SUITE 403
ASTORIA NY
11106-2329
US
V. Phone/Fax
- Phone: 718-224-2867
- Fax: 718-224-3782
- Phone: 718-707-0717
- Fax: 718-707-6977
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GERARD
MOUNIC
Title or Position: DIRECTOR OCCUPATIONAL THERAPY
Credential: OT
Phone: 718-224-3867