Healthcare Provider Details

I. General information

NPI: 1265706147
Provider Name (Legal Business Name): TENDER LOVING CARE OCCUPATIONAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 BAINBRIDGE AVE
BRONX NY
10467-1411
US

IV. Provider business mailing address

3555 BAINBRIDGE AVE
BRONX NY
10467-1411
US

V. Phone/Fax

Practice location:
  • Phone: 718-652-3535
  • Fax: 718-652-2323
Mailing address:
  • Phone: 718-652-3535
  • Fax: 718-652-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES J JOHNSON
Title or Position: OWNER
Credential: MS/OTR/L
Phone: 718-652-3535