Provider Demographics
NPI:1154713840
Name:SENSATIONAL KIDS OCCUPATIONAL THERAPY PC
Entity type:Organization
Organization Name:SENSATIONAL KIDS OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SUTORIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L
Authorized Official - Phone:914-815-0717
Mailing Address - Street 1:1076 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-3407
Mailing Address - Country:US
Mailing Address - Phone:914-815-0717
Mailing Address - Fax:
Practice Address - Street 1:1076 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-3407
Practice Address - Country:US
Practice Address - Phone:914-815-0717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013696-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services