MEDICARE: THRIVE REHAB OT 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1982238242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE REHAB OT PLLC

Provider Business Mailing Address
First Line	:	2547 E 12TH ST APT 1A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5056
Country	:	US
Telephone Number	:	646-417-3250
Fax Number	:

Provider Business Practice Location Address
First Line	:	2547 E 12TH ST APT 1A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5056
Country	:	US
Telephone Number	:	646-417-3250
Fax Number	:

Authorized Official
Title or Position	:	CO-PRESIDENT
Name	:	DANIEL NASS
Credential	:	OTR/L
Telephone Number	:	646-417-3250

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	02/26/2020

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