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NPI Code Detail

MEDICARE: SG OCCUPATIONAL THERAPY PC

MEDICARE: SG OCCUPATIONAL THERAPY PC
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1427365923
Entity Type Code : Organization
Provider Name (Legal Business Name) : SG OCCUPATIONAL THERAPY PC
Provider Business Mailing Address
First Line : 935 TODT HILL RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-1319
Country : US
Telephone Number : 718-541-7109
Fax Number : 718-317-6391
Provider Business Practice Location Address
First Line : 3936 AMBOY RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-2406
Country : US
Telephone Number : 718-541-7109
Fax Number : 718-317-6390
Authorized Official
Title or Position : PRESIDENT
Name : SUSAN GREENBERG
Credential : OTR/L
Telephone Number : 718-541-7109
Provider Enumeration Date : 09/03/2010
Last Update Date : 09/04/2010

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Directions to “SG OCCUPATIONAL THERAPY PC ” Practice Location

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