MEDICARE: RONALD S. CIACCIA OCCUPATIONAL THERAPIST P.C.

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	320700000X	Physical Disabilities Residential Treatment Facility	012203	NY

General Provider Information

NPI Number	:	1265635007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD S. CIACCIA OCCUPATIONAL THERAPIST P.C.

Provider Business Mailing Address
First Line	:	8728 - 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8728 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4526
Country	:	US
Telephone Number	:	718-259-2618
Fax Number	:	718-259-2618

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RONALD SILVIO CIACCIA
Credential	:	OTR&L
Telephone Number	:	718-259-2618

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	08/22/2020

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