MEDICARE: SINCERE 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	006327	NY

General Provider Information

NPI Number	:	1326436346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINCERE OCCUPATIONAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	4825 39TH ST
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-4513
Country	:	US
Telephone Number	:	917-716-9076
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 39TH ST
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-4513
Country	:	US
Telephone Number	:	917-716-9076
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHING KUNG LI
Credential	:	OT
Telephone Number	:	917-716-9076

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	12/29/2014

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