Healthcare Provider Details

I. General information

NPI: 1518632892
Provider Name (Legal Business Name): SPEAR PHYSICAL AND OCCUPATIONAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 N 7TH ST
BROOKLYN NY
11249-3005
US

IV. Provider business mailing address

31 E 32ND ST FL 4
NEW YORK NY
10016-5595
US

V. Phone/Fax

Practice location:
  • Phone: 646-829-2295
  • Fax: 212-379-2131
Mailing address:
  • Phone: 646-973-5427
  • Fax: 212-379-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOE DAMIANO
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 646-973-5427