Provider Demographics
NPI:1124652532
Name:THERACONTRACTORS INC
Entity type:Organization
Organization Name:THERACONTRACTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, PTA
Authorized Official - Phone:917-364-1721
Mailing Address - Street 1:7504 188TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1703
Mailing Address - Country:US
Mailing Address - Phone:917-364-1721
Mailing Address - Fax:
Practice Address - Street 1:7504 188TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1703
Practice Address - Country:US
Practice Address - Phone:917-364-1721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency