Healthcare Provider Details

I. General information

NPI: 1528796463
Provider Name (Legal Business Name): SENSORY FILTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 GARTH RD APT 6Q
SCARSDALE NY
10583-3817
US

IV. Provider business mailing address

190 GARTH RD APT 6Q
SCARSDALE NY
10583-3817
US

V. Phone/Fax

Practice location:
  • Phone: 917-528-0607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MIMI MAMO TESSEMA
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 917-528-0607