Provider Demographics
NPI:1316284482
Name:DRAGON OCCUPATIONAL THERAPY P.C.
Entity type:Organization
Organization Name:DRAGON OCCUPATIONAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:RAFOL
Authorized Official - Last Name:RABINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-755-1953
Mailing Address - Street 1:8115 QUEENS BLVD APT 7A
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3778
Mailing Address - Country:US
Mailing Address - Phone:917-755-1953
Mailing Address - Fax:
Practice Address - Street 1:8115 QUEENS BLVD APT 7A
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3778
Practice Address - Country:US
Practice Address - Phone:917-755-1953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014632-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty