Provider Demographics
NPI:1285991422
Name:KIDS IN MOTION OT, PLLC
Entity type:Organization
Organization Name:KIDS IN MOTION OT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-601-7400
Mailing Address - Street 1:2735 HENRY HUDSON PKWY W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4701
Mailing Address - Country:US
Mailing Address - Phone:718-601-7400
Mailing Address - Fax:718-601-7401
Practice Address - Street 1:2735 HENRY HUDSON PKWY W
Practice Address - Street 2:SUITE 102
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4701
Practice Address - Country:US
Practice Address - Phone:718-601-7400
Practice Address - Fax:718-601-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center