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General NPI Number Information
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NPI Number | 1295946713
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Entity Type | Organization
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Legal Business Name | EAST NORWICH THERAPEUTIC SERVICES, OT, PC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 CALVERT DR
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City | SYOSSET
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State | NY
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Zip | 11791-2905
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Country | US
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Telephone | 516-677-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CALVERT DR
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City | SYOSSET
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State | NY
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Zip | 11791-2905
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Country | US
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Telephone | 516-677-1994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ROSALIE MENDUNI
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Credential | MA OTR L
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Telephone | 516-677-1994
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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 |
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License Number State |
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