Healthcare Provider Details

I. General information

NPI: 1033426531
Provider Name (Legal Business Name): ONE STEP BEYOND SLP OT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3936 AMBOY RD
STATEN ISLAND NY
10308-2406
US

IV. Provider business mailing address

3936 AMBOY RD
STATEN ISLAND NY
10308-2406
US

V. Phone/Fax

Practice location:
  • Phone: 718-317-6390
  • Fax: 718-317-6391
Mailing address:
  • Phone: 718-317-6390
  • Fax: 718-317-6391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN GREENBERG
Title or Position: DIRECTOR
Credential: OTR/L
Phone: 717-317-6390