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General NPI Number Information
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NPI Number | 1801379300
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Entity Type | Organization
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Legal Business Name | COMPLETE OT AND OTA SERVICES PLLC
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 2545 HEMPSTEAD TPKE STE LL4
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City | EAST MEADOW
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State | NY
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Zip | 11554-2143
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Country | US
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Telephone | 516-330-2912
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Fax |
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Provider Business Mailing Address
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Address Line | 2545 HEMPSTEAD TPKE STE LL4
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City | EAST MEADOW
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State | NY
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Zip | 11554-2143
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Country | US
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Telephone | 516-330-2912
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Fax |
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Authorized Official
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Title or Position | OTR
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Name | DIANE CLUNE
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Credential | OT
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Telephone | 516-330-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 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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