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General NPI Number Information
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NPI Number | 1770828238
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Entity Type | Organization
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Legal Business Name | OT ACCESS PC
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 11524 MYRTLE AVE
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1717
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Country | US
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Telephone | 347-201-5111
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Fax | 347-547-3093
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Provider Business Mailing Address
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Address Line | 15218 UNION TPKE APT 12N
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City | FLUSHING
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State | NY
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Zip | 11367-3921
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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/OWNER
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Name | MS. JENNIFER MIGUEL DELOS SANTOS
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Credential | OTR/L
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Telephone | 347-443-6524
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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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