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NPI Code Detail

MEDICARE: BROOKLYN OCCUPATIONAL THERAPY PC

MEDICARE: BROOKLYN 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
1174400000XSpecialist009500NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1009500OTHERNYLICENSE NO.

General Provider Information

NPI Number : 1720312960
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKLYN OCCUPATIONAL THERAPY PC
Provider Business Mailing Address
First Line : 2752 OCEAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-4706
Country : US
Telephone Number : 718-769-9001
Fax Number :
Provider Business Practice Location Address
First Line : 2752 OCEAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-4706
Country : US
Telephone Number : 718-769-9001
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPY
Name : MR. VICTOR GENKIN
Credential : O.T.
Telephone Number : 718-769-9001
Provider Enumeration Date : 09/21/2009
Last Update Date : 09/21/2009

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Directions to “BROOKLYN OCCUPATIONAL THERAPY PC ” Practice Location

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