MEDICARE: OYSTER BAY OCCUPATIONAL 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	251E00000X	Home Health Agency
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1851158422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OYSTER BAY OCCUPATIONAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	600 PINE HOLLOW RD APT 11-1B
Second Line	:
City	:	EAST NORWICH
State	:	NY
Zip	:	11732-1029
Country	:	US
Telephone Number	:	516-404-2795
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 PINE HOLLOW RD APT 11-1B
Second Line	:
City	:	EAST NORWICH
State	:	NY
Zip	:	11732-1029
Country	:	US
Telephone Number	:	516-404-2795
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	CAITLIN BOWE
Credential	:	MS, OTR/L, CSRS
Telephone Number	:	516-404-2795

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	02/29/2024

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