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NPI Code Detail

MEDICARE: THE SENSORY MOTOR INTEGRATION AND LANGUAGE ENRICHMENT THERAPEUTIC SERV

MEDICARE: THE SENSORY MOTOR INTEGRATION AND LANGUAGE ENRICHMENT THERAPEUTIC SERV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TM1800XIntellectual & Developmental Disabilities Psychologist
21041C0700XClinical Social Worker
32251P0200XPediatric Physical Therapist
4225XP0200XPediatric Occupational Therapist
5235Z00000XSpeech-Language Pathologist
6252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1023248879
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE SENSORY MOTOR INTEGRATION AND LANGUAGE ENRICHMENT THERAPEUTIC SERV
Provider Business Mailing Address
First Line : 171 MADISON AVE FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10016-5123
Country : US
Telephone Number : 212-400-0383
Fax Number : 212-400-0384
Provider Business Practice Location Address
First Line : 171 MADISON AVE FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10016-5123
Country : US
Telephone Number : 212-400-0383
Fax Number : 212-400-0384
Authorized Official
Title or Position : CEO & PROGRAM DIRECTOR
Name : MR. SHIOU JUNG HO
Credential : MA, OTR/L
Telephone Number : 212-400-0383
Provider Enumeration Date : 07/14/2009
Last Update Date : 07/14/2009

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