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General NPI Number Information
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NPI Number | 1902215270
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Entity Type | Organization
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Legal Business Name | ROBERT V. GIUDICE, OTR/L, P.C.
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 212 1ST ST
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-3508
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Country | US
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Telephone | 631-398-9675
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Fax | 631-623-6714
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Provider Business Mailing Address
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Address Line | 212 1ST ST
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-3508
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Country | US
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Telephone | 631-398-9675
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Fax | 631-623-6714
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT V GIUDICE
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Credential | OTR/L
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Telephone | 631-398-9675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1074952
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License Number State | NY
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