Healthcare Provider Details

I. General information

NPI: 1841959947
Provider Name (Legal Business Name): SPEAR PHYSICAL AND OCCUPATIONAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 COURT ST
BROOKLYN NY
11231-4405
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 646-518-5560
  • Fax: 646-805-1078
Mailing address:
  • Phone: 646-518-5562
  • Fax:

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: AMY LEUNG
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 646-518-5562