Healthcare Provider Details

I. General information

NPI: 1962545426
Provider Name (Legal Business Name): NORTH SHORE OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EXPRESSWAY PLZ SUITE 106
ROSLYN HEIGHTS NY
11577-2047
US

IV. Provider business mailing address

1 EXPRESSWAY PLZ SUITE 106
ROSLYN HEIGHTS NY
11577-2047
US

V. Phone/Fax

Practice location:
  • Phone: 516-625-6600
  • Fax: 516-625-1819
Mailing address:
  • Phone: 516-625-6600
  • Fax: 516-625-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0012270
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0012270
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0012270
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number001270
License Number StateNY

VIII. Authorized Official

Name: ANN GOLDBERG
Title or Position: DIRECTOR
Credential: OTR, CHT
Phone: 516-625-6600