Healthcare Provider Details

I. General information

NPI: 1346911989
Provider Name (Legal Business Name): OCCUPATIONAL THERAPY JUNCTIONS LEAH FAZAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 OAK ST
PATCHOGUE NY
11772-2883
US

IV. Provider business mailing address

367 N OCEAN AVE
PATCHOGUE NY
11772-2014
US

V. Phone/Fax

Practice location:
  • Phone: 631-384-8621
  • Fax:
Mailing address:
  • Phone: 718-791-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. LEAH FAZAL
Title or Position: OWNER
Credential: OTR/L
Phone: 718-791-8950