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General NPI Number Information
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NPI Number | 1083848683
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Entity Type | Organization
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Legal Business Name | LIHT OCCUPATIONAL THERAPY PC
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 77 3RD ST
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City | STAMFORD
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State | CT
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Zip | 06905-4722
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Country | US
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Telephone | 516-505-2200
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Fax | 516-505-5416
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Provider Business Mailing Address
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Address Line | 300 HEMPSTEAD TPKE SUITE 3
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-1450
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Country | US
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Telephone | 516-505-2200
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Fax | 516-505-5416
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JENNIFER M DEFEO
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Credential | OT
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Telephone | 515-505-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 003533
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License Number State | CT
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