Healthcare Provider Details

I. General information

NPI: 1750625703
Provider Name (Legal Business Name): SENSATIONAL DEVELOPMENT OT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 BROADWAY
MASSAPEQUA NY
11758-2314
US

IV. Provider business mailing address

669 BROADWAY
MASSAPEQUA NY
11758-2314
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-2900
  • Fax: 516-799-2928
Mailing address:
  • Phone: 516-799-2900
  • Fax: 516-799-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARA PEREIRA
Title or Position: BOSS
Credential: OTR/L
Phone: 516-799-2900