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General NPI Number Information
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NPI Number | 1194126581
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Entity Type | Organization
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Legal Business Name | SPECTRUM OCCUPATIONAL THERAPY, PC
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 8400 SHORE FRONT PKWY APT 5A
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1809
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Country | US
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Telephone | 646-620-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 SHORE FRONT PKWY APT 5A
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1809
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Country | US
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Telephone | 646-620-0403
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELENA DRAPKIN
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Credential | OTR/L, MS
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Telephone | 646-620-0403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 013504
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License Number State | NY
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