MEDICARE: CONNECT AND FLOW OT 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1811320344	OTHER	NY	NPI

General Provider Information

NPI Number	:	1083436703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECT AND FLOW OT PLLC

Provider Business Mailing Address
First Line	:	312 BLEDSOE AVENUE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27601-2606
Country	:	US
Telephone Number	:	845-625-4849
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 BLEDSOE AVENUE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27601-2606
Country	:	US
Telephone Number	:	845-625-4849
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OCCUPATIONAL THERAPIST
Name	:	ALEXANDRA FERT
Credential	:	OTR/L
Telephone Number	:	845-625-4849

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	10/25/2024

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