Healthcare Provider Details
I. General information
NPI: 1164710596
Provider Name (Legal Business Name): SUNSHINE RN PT OT SLP & PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 SPRING VALLEY RD
OSSINING NY
10562-2001
US
IV. Provider business mailing address
15 SPRING VALLEY RD
OSSINING NY
10562-2001
US
V. Phone/Fax
- Phone: 914-333-7098
- Fax: 914-762-7054
- Phone: 914-333-7098
- Fax: 914-762-7054
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
MOSIELLO
Title or Position: MANAGING MEMBER
Credential:
Phone: 914-333-7098