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General NPI Number Information
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NPI Number | 1821750043
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Entity Type | Organization
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Legal Business Name | THE INSPIRED OT PC
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 776 GRAND TERRACE AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1421
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Country | US
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Telephone | 516-633-7254
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Fax |
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Provider Business Mailing Address
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Address Line | 776 GRAND TERRACE AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1421
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Country | US
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Telephone | 516-633-7254
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DALE A COFFIN
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Credential | OTR/L, EDD
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Telephone | 516-637-2544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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