1619186376 NPI number — HAND&OCCUPATIONAL THERAPY,PC

Table of content: (NPI 1619186376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619186376 NPI number — HAND&OCCUPATIONAL THERAPY,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAND&OCCUPATIONAL THERAPY,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619186376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
188 W MONTAUK HWY
Provider Second Line Business Mailing Address:
SUITE E6
Provider Business Mailing Address City Name:
HAMPTON BAYS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11946-2363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-728-7875
Provider Business Mailing Address Fax Number:
631-728-8204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
188 W MONTAUK HWY
Provider Second Line Business Practice Location Address:
SUITE E6
Provider Business Practice Location Address City Name:
HAMPTON BAYS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11946-2363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-728-7875
Provider Business Practice Location Address Fax Number:
631-728-8204
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASH
Authorized Official First Name:
CORNELIUS
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
631-728-7875

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  005924-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 210401 . This is a "ETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 93542 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01949733 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 99710 . This is a "SIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AZ00901 . This is a "MDNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1272767 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 201388 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 941863 . This is a "ACN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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