=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891329926
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MY ABILITIES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2020
-----------------------------------------------------
Last Update Date | 08/21/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 NIMITZ PL
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10710-1308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-539-6377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 NIMITZ PL
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10710-1308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-539-6377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | ROCIO ISABEL FRIAS
-----------------------------------------------------
Credential | MS OTR/L
-----------------------------------------------------
Telephone | 917-539-6377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------