Provider Demographics
NPI:1124240809
Name:EMPIRE HAND OCCUPATIONAL THERAPY, PLLC
Entity type:Organization
Organization Name:EMPIRE HAND OCCUPATIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FESTA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:315-251-1006
Mailing Address - Street 1:183 INTREPID LANE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205
Mailing Address - Country:US
Mailing Address - Phone:315-251-1006
Mailing Address - Fax:315-251-1099
Practice Address - Street 1:183 INTREPID LANE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205
Practice Address - Country:US
Practice Address - Phone:315-251-1006
Practice Address - Fax:315-251-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63 007223225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1554Medicare ID - Type Unspecified
NY4753680001Medicare NSC