MEDICARE: JAMES SURIDIS JR OCCUPATIONAL THERAPY PLLC

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1043175011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES SURIDIS JR OCCUPATIONAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	3127 CRESCENT ST APT 4A
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-3778
Country	:	US
Telephone Number	:	516-413-8125
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 CRESCENT ST APT 4A
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-3778
Country	:	US
Telephone Number	:	516-413-8125
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	JAMES E SURIDIS JR.
Credential	:	MS, OTR/L
Telephone Number	:	516-413-8125

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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