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General NPI Number Information
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NPI Number | 1861673006
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Entity Type | Organization
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Legal Business Name | PEDIATRIC EARLY DEVELOPMENT SERVICES, OT, PC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 1208 154TH ST
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City | WHITESTONE
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State | NY
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Zip | 11357-1957
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Country | US
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Telephone | 917-584-7671
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Fax | 718-746-1624
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Provider Business Mailing Address
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Address Line | 1208 154TH ST
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City | WHITESTONE
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State | NY
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Zip | 11357-1957
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Country | US
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Telephone |
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Fax | 718-746-1624
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLAUDIA HASBUN
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Credential | OTR/L
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Telephone | 917-584-7671
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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 | 013046-1
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License Number State | NY
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