Provider Demographics
NPI:1306092226
Name:SUPPORT BY DESIGN, OT, SLP,PT, PLLC
Entity type:Organization
Organization Name:SUPPORT BY DESIGN, OT, SLP,PT, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SADIA
Authorized Official - Middle Name:SULTANA
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:212-608-9661
Mailing Address - Street 1:8 BEACH STREET
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-608-9661
Mailing Address - Fax:212-608-9660
Practice Address - Street 1:8 BEACH STREET
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-608-9661
Practice Address - Fax:212-608-9660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X, 225XP0200X, 252Y00000X, 235Z00000X
NY005795-1174400000X
NY015894-1174400000X
NY016457-1174400000X
NY013880-1174400000X
NY026087-1174400000X
NY031150-1174400000X
NY018231-1235Z00000X
NY016935-1235Z00000X
NY014737-1235Z00000X
NY017408-1235Z00000X
NY019744-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty