Healthcare Provider Details

I. General information

NPI: 1356740708
Provider Name (Legal Business Name): OISIN MCELLIGOTT MS, OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 AVIS CT
BLAUVELT NY
10913-1006
US

IV. Provider business mailing address

4 AVIS CT
BLAUVELT NY
10913-1006
US

V. Phone/Fax

Practice location:
  • Phone: 845-653-1603
  • Fax:
Mailing address:
  • Phone: 845-653-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number025718-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number64008470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: