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General NPI Number Information
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NPI Number | 1821389016
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Entity Type | Organization
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Legal Business Name | LITTLE ANGELS OCCUPATIONAL THERAPY, PC
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 222 BEACH 91ST ST APT. #1
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1508
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Country | US
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Telephone | 917-355-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 222 BEACH 91ST ST APT. #1
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1508
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Country | US
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Telephone | 917-355-9898
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Fax |
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Authorized Official
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Title or Position | OTR/L
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Name | MS. LYNETTE JACQUELINE PERRY
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Credential | OCCUPATIONAL THERAPI
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Telephone | 917-355-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 008213-1
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License Number State | NY
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