Healthcare Provider Details

I. General information

NPI: 1164791729
Provider Name (Legal Business Name): ELLEN HECHT O.T.R.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 NORTHERN PARKWAY WEST
PLAINVIEW NY
11803
US

IV. Provider business mailing address

72 NORTHERN PARKWAY WEST
PLAINVIEW NY
11803
US

V. Phone/Fax

Practice location:
  • Phone: 516-935-9279
  • Fax:
Mailing address:
  • Phone: 516-935-9279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1846-1
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: