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General NPI Number Information
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NPI Number | 1508356056
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL STEPS, INC
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 14444 69TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-1702
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Country | US
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Telephone | 646-409-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 14444 69TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-1702
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Country | US
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Telephone | 646-409-9011
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Fax |
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Authorized Official
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Title or Position | OT
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Name | KHANA KATANOV
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Credential | OTR/L
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Telephone | 646-409-9011
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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 | 017406
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License Number State | NY
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