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General NPI Number Information
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NPI Number | 1588041776
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Entity Type | Organization
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Legal Business Name | ESSENTIAL THERAPY PT OT AND SLP PLLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 1526 NEW HAVEN AVE
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-5148
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Country | US
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Telephone | 718-471-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 6202 20TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-3023
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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 | PARTNER
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Name | MR. ISRAEL CYWIAK
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Credential | OTR/L
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Telephone | 917-544-3060
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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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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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