Healthcare Provider Details

I. General information

NPI: 1194632927
Provider Name (Legal Business Name): SMALL MOMENTS OCCUPATIONAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 E MAIN ST
WASHINGTONVILLE NY
10992-1215
US

IV. Provider business mailing address

657 BEATTIE RD
ROCK TAVERN NY
12575-5264
US

V. Phone/Fax

Practice location:
  • Phone: 845-728-9306
  • Fax: 845-614-0223
Mailing address:
  • Phone: 845-728-9306
  • Fax: 845-614-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEANINE GOW
Title or Position: OCCUPATIONAL THERAPIST
Credential: MS,OTR/L
Phone: 845-728-9306