Healthcare Provider Details

I. General information

NPI: 1427249242
Provider Name (Legal Business Name): IRIT PINKUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SPLIT ROCK RD
CHESTER NY
10918-1709
US

IV. Provider business mailing address

7 SPLIT ROCK RD
CHESTER NY
10918-1709
US

V. Phone/Fax

Practice location:
  • Phone: 845-782-5084
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0120961
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: