MEDICARE: OMNI

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	251300000X	Local Education Agency (LEA)	021311-1	NY

General Provider Information

NPI Number	:	1720515430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI

Provider Business Mailing Address
First Line	:	1928 E 26TH ST
Second Line	:	BSMT
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2440
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 E 26TH ST
Second Line	:	BSMT
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2440
Country	:	US
Telephone Number	:	973-471-6685
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	PAMELA STEINBERG
Credential	:
Telephone Number	:	973-767-4255

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	05/12/2017

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Directions to “OMNI ” Practice Location

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