Healthcare Provider Details

I. General information

NPI: 1689332306
Provider Name (Legal Business Name): HUDSON HOME OT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 ST HWY 211
OTISVILLE NY
10963-2711
US

IV. Provider business mailing address

1722 ST HWY 211
OTISVILLE NY
10963-2711
US

V. Phone/Fax

Practice location:
  • Phone: 914-260-1953
  • Fax:
Mailing address:
  • Phone: 914-260-1953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TARA MURPHY
Title or Position: OTR/L
Credential: MS OT
Phone: 914-260-1953