Healthcare Provider Details

I. General information

NPI: 1194964312
Provider Name (Legal Business Name): EILEEN O'ROURKE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NASSAU UNIVERSITY MEDICAL CENTER 2201 HEMSPTEAD TURNPIKE
EAST MEADOW NY
11554
US

IV. Provider business mailing address

NASSAU UNIVERSITY MEDICAL CENTER 2201 HEMSPTEAD TURNPIKE
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6131
  • Fax: 516-572-5793
Mailing address:
  • Phone: 516-572-6131
  • Fax: 516-572-5793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number015459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: