Healthcare Provider Details

I. General information

NPI: 1396071007
Provider Name (Legal Business Name): CELESTIAL OCCUPATIONAL THERAPY OF GREAT NECK P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2009
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SUNNYSIDE BLVD SUITE G-3
PLAINVIEW NY
11803-1517
US

IV. Provider business mailing address

54 SUNNYSIDE BLVD SUITE G-3
PLAINVIEW NY
11803-1517
US

V. Phone/Fax

Practice location:
  • Phone: 516-931-6868
  • Fax: 516-931-6869
Mailing address:
  • Phone: 516-931-6868
  • Fax: 516-931-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
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: MS. MIRIAM KAPLAN
Title or Position: DIRECTOR
Credential: OTR/L
Phone: 516-931-6868