1275953317 NPI number — APPLE BLOSSOM OCCUPATIONAL THERAPY SERVICES PLLC.

Table of content: (NPI 1275953317)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275953317 NPI number — APPLE BLOSSOM OCCUPATIONAL THERAPY SERVICES PLLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APPLE BLOSSOM OCCUPATIONAL THERAPY SERVICES PLLC.
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:
1275953317
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 E 86TH ST
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-3003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-210-2963
Provider Business Mailing Address Fax Number:
917-508-4856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 E 33RD ST
Provider Second Line Business Practice Location Address:
APT 15D
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-5338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-210-2963
Provider Business Practice Location Address Fax Number:
917-508-4856
Provider Enumeration Date:
04/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
KHANDARE
Authorized Official First Name:
VAISHALI
Authorized Official Middle Name:
PRAKASH
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
347-210-2963

Provider Taxonomy Codes

  • Taxonomy code: 261QD1600X , with the licence number:  010190 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0401X , with the licence number: 010190 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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