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NPI Code Detail

MEDICARE: EISNY OT/PT/SLP PLLC

MEDICARE: EISNY OT/PT/SLP 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
1252Y00000XEarly Intervention Provider Agency25296NY

General Provider Information

NPI Number : 1366768319
Entity Type Code : Organization
Provider Name (Legal Business Name) : EISNY OT/PT/SLP PLLC
Provider Business Mailing Address
First Line : PO BOX 441
Second Line :
City : SOMERS
State : NY
Zip : 10589-0441
Country : US
Telephone Number : 914-373-6520
Fax Number : 914-373-6521
Provider Business Practice Location Address
First Line : 189 ROUTE 100
Second Line :
City : SOMERS
State : NY
Zip : 10589-2811
Country : US
Telephone Number : 914-373-6520
Fax Number : 914-373-6521
Authorized Official
Title or Position : MANAGING MEMBER
Name : MANJUSHA MEHRA
Credential : OTR
Telephone Number : 914-373-6520
Provider Enumeration Date : 04/15/2010
Last Update Date : 04/15/2010

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Directions to “EISNY OT/PT/SLP PLLC ” Practice Location

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