Provider Demographics
NPI:1104965094
Name:OUT EAST OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:OUT EAST OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBLER SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:631-375-5313
Mailing Address - Street 1:77 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 COUNTY ROAD 39A
Practice Address - Street 2:STE 204
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5277
Practice Address - Country:US
Practice Address - Phone:631-375-5313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health