Healthcare Provider Details

I. General information

NPI: 1205614971
Provider Name (Legal Business Name): ACHIEVE AT HOME PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 STRATHMORE RD
GREAT NECK NY
11023-1035
US

IV. Provider business mailing address

25 STRATHMORE RD
GREAT NECK NY
11023-1035
US

V. Phone/Fax

Practice location:
  • Phone: 917-771-7290
  • Fax: 516-447-4719
Mailing address:
  • Phone: 917-771-7290
  • Fax: 516-447-4719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: AMIR AMRAMI
Title or Position: OWNER
Credential: PT, DPT
Phone: 917-771-7290