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General NPI Number Information
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NPI Number | 1861303091
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Entity Type | Organization
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Legal Business Name | OUR PATCHWORK KIDZ LLC
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 66 CRISFIELD ST APT 1Q
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City | YONKERS
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State | NY
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Zip | 10710-1242
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Country | US
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Telephone | 845-300-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 66 CRISFIELD ST APT 1Q
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City | YONKERS
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State | NY
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Zip | 10710-1242
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Country | US
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Telephone | 845-300-0693
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | LADYBIRD MANANGAN REYES
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Credential | PT
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Telephone | 845-300-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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