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General NPI Number Information
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NPI Number | 1649620279
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Entity Type | Organization
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Legal Business Name | DOVE OCCUPATIONAL THERAPY PC
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 11 CHRISTOPHER CT
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City | MIDDLETOWN
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State | NY
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Zip | 10941-2054
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Country | US
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Telephone | 917-696-2036
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CHRISTOPHER CT
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City | MIDDLETOWN
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State | NY
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Zip | 10941-2054
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Country | US
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Telephone | 917-696-2036
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY/ OWNER
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Name | MRS. ARELIS CUEVAS
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Credential | MSOTR/L
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Telephone | 917-696-2036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 014475-1
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License Number State | NY
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