Healthcare Provider Details

I. General information

NPI: 1184898538
Provider Name (Legal Business Name): KIDABILITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SKYLINE DR SUITE 298
HAWTHORNE NY
10532-2157
US

IV. Provider business mailing address

1 SKYLINE DR SUITE 298
HAWTHORNE NY
10532-2157
US

V. Phone/Fax

Practice location:
  • Phone: 914-347-5990
  • Fax: 914-347-5236
Mailing address:
  • Phone: 914-347-5990
  • Fax: 914-347-5236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number017111-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number001998-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number001626-1
License Number StateNY

VIII. Authorized Official

Name: SUE SEILER
Title or Position: DIRECTOR
Credential: OT/L
Phone: 914-347-5990