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General NPI Number Information
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NPI Number | 1730467572
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Entity Type | Organization
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Legal Business Name | HOME ADVANTAGE OCCUPATIONAL THERAPY, P.C.
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 2721 LEE PL
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City | BELLMORE
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State | NY
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Zip | 11710-5003
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Country | US
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Telephone | 516-729-4834
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Fax | 516-706-2182
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Provider Business Mailing Address
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Address Line | 2721 LEE PL
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City | BELLMORE
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State | NY
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Zip | 11710-5003
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Country | US
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Telephone | 516-729-4834
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Fax | 516-706-2182
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL JOHN MARZANO
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Credential | OTR/L
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Telephone | 516-729-4834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 010005
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License Number State | NY
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