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General NPI Number Information
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NPI Number | 1588034417
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Entity Type | Organization
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Legal Business Name | THERAPLAY
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 19 RIDGEFIELD RD
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City | NEW CITY
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State | NY
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Zip | 10956-5425
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Country | US
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Telephone | 914-329-7821
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Fax |
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Provider Business Mailing Address
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Address Line | 19 RIDGEFIELD RD
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City | NEW CITY
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State | NY
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Zip | 10956-5425
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MS. ILYSSA NATELSON
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Credential |
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Telephone | 914-329-7821
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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 | 811627996
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License Number State | NY
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