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General NPI Number Information
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NPI Number | 1720644404
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Entity Type | Organization
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Legal Business Name | K.B. OCCUPATIONAL THERAPY P.C.
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 898 OYSTER BAY RD
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City | EAST NORWICH
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State | NY
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Zip | 11732-1051
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Country | US
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Telephone | 516-581-6499
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Fax |
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Provider Business Mailing Address
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Address Line | 264 N RICHMOND AVE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-3229
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Country | US
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Telephone | 516-581-6499
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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 | KIMBERLY BISHOP
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Credential | MS OTR/L
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Telephone | 516-581-6499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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