MEDICARE: V&L OCCUPATIONAL AND PHYSICAL 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	225100000X	Physical Therapist	025591	NY
2	225X00000X	Occupational Therapist	015094	NY

General Provider Information

NPI Number	:	1740562537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V&L OCCUPATIONAL AND PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	9205 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-2428
Country	:	US
Telephone Number	:	718-684-1996
Fax Number	:

Provider Business Practice Location Address
First Line	:	9205 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-2428
Country	:	US
Telephone Number	:	718-684-1996
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VALERIA GROYSMAN
Credential	:	OTR
Telephone Number	:	718-684-1996

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	09/16/2011

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