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General NPI Number Information
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NPI Number | 1821381922
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Entity Type | Organization
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Legal Business Name | TRINITY PHYSICAL OCCUPATIONAL AND SPEECH THERAPY
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 1454 ROUTE 22 SUITE B101,B102
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City | BREWSTER
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State | NY
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Zip | 10509-4346
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Country | US
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Telephone | 845-279-5111
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Fax | 845-279-5121
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Provider Business Mailing Address
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Address Line | 1454 ROUTE 22 SUITE B101,B102
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City | BREWSTER
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State | NY
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Zip | 10509-4346
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Country | US
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Telephone | 845-279-5111
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Fax | 845-279-5121
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | MRS. JENNIFER DARBY
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Credential | PT
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Telephone | 845-279-5111
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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 | 023515
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License Number State | NY
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