Healthcare Provider Details
I. General information
NPI: 1609791730
Provider Name (Legal Business Name): OT THERAPEUTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
179 SOUND RD
WADING RIVER NY
11792-1032
US
IV. Provider business mailing address
179 SOUND RD
WADING RIVER NY
11792-1032
US
V. Phone/Fax
- Phone: 631-561-7383
- Fax: 631-251-7013
- Phone: 631-561-7383
- Fax: 631-251-7013
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHARON
CHRISTINA
BENDZLOWICZ-VOGT
Title or Position: PRESIDENT/ OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 631-561-7383