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General NPI Number Information
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NPI Number | 1841526399
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Entity Type | Organization
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Legal Business Name | OUTREACH PHYSICAL AND OCCUPATIONAL THERAPY & SPEECH REHABILITATION, PLLC
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3 GRACE AVENUE SUITE 119
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 212-842-0080
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Fax | 917-591-8494
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Provider Business Mailing Address
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Address Line | 3 GRACE AVENUE SUITE 119
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 212-842-0080
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Fax | 917-591-8494
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Authorized Official
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Title or Position | OPERATIONS
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Name | ALEX GREENSPAN
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Credential | MSPT
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Telephone | 212-842-0080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0248891
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License Number State | NY
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