Provider Demographics
NPI:1992172332
Name:BUILDING BRIDGES THROUGH OT
Entity type:Organization
Organization Name:BUILDING BRIDGES THROUGH OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUZGAL-NACLERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-667-6158
Mailing Address - Street 1:110 N GREENBUSH RD
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1606
Mailing Address - Country:US
Mailing Address - Phone:917-667-6158
Mailing Address - Fax:
Practice Address - Street 1:110 N GREENBUSH RD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-1606
Practice Address - Country:US
Practice Address - Phone:917-667-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011624225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty