Healthcare Provider Details

I. General information

NPI: 1093020257
Provider Name (Legal Business Name): NR-OT HAND REHAB PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5847 FRANCIS LEWIS BLVD STE 200
OAKLAND GARDENS NY
11364-1601
US

IV. Provider business mailing address

5847 FRANCIS LEWIS BLVD STE 200
OAKLAND GARDENS NY
11364-1601
US

V. Phone/Fax

Practice location:
  • Phone: 718-454-0842
  • Fax: 718-454-1704
Mailing address:
  • Phone: 718-454-0842
  • Fax: 718-454-1704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0053121
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0053121
License Number StateNY

VIII. Authorized Official

Name: MR. NICOLA ROSELLI
Title or Position: OWNER
Credential: OTR.CHT
Phone: 718-454-0842