Provider Demographics
NPI:1588863039
Name:THERAPY FOR KIDS,OT,PT,SLP,LLC
Entity type:Organization
Organization Name:THERAPY FOR KIDS,OT,PT,SLP,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AVIGDOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA,OTR/L
Authorized Official - Phone:718-793-5202
Mailing Address - Street 1:6868 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1325
Mailing Address - Country:US
Mailing Address - Phone:718-793-5202
Mailing Address - Fax:718-793-5207
Practice Address - Street 1:6868 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1325
Practice Address - Country:US
Practice Address - Phone:718-793-5202
Practice Address - Fax:718-793-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2137225X00000X
NY7363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty