Healthcare Provider Details

I. General information

NPI: 1326370180
Provider Name (Legal Business Name): S & C KIDS POWER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 E 112TH ST
NEW YORK NY
10029-2913
US

IV. Provider business mailing address

236 EAST 112TH STREET
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-348-0610
  • Fax: 212-348-0241
Mailing address:
  • Phone: 212-348-0610
  • Fax: 212-348-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number030543-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number013570-1
License Number StateNY

VIII. Authorized Official

Name: CYRUS DURING
Title or Position: OCUUPATIONAL THERAPIST
Credential: OTR/L
Phone: 212-348-0610