Provider Demographics
NPI:1154727980
Name:KOULIS TENDER TOUCH OCCUPATIONAL THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:KOULIS TENDER TOUCH OCCUPATIONAL THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETORS
Authorized Official - Prefix:MISS
Authorized Official - First Name:KOULI
Authorized Official - Middle Name:EFTICHIA
Authorized Official - Last Name:NALPANTIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-405-3044
Mailing Address - Street 1:3018 CORLEAR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5141
Mailing Address - Country:US
Mailing Address - Phone:917-405-3044
Mailing Address - Fax:718-796-1230
Practice Address - Street 1:3434 TIBBETT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3709
Practice Address - Country:US
Practice Address - Phone:917-405-3044
Practice Address - Fax:718-796-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011888-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency