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Organization
OCCUPATIONAL THERAPY CLUBHOUSE, PC
Active
Organization
OCCUPATIONAL THERAPY CLUBHOUSE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS VIRGINIA O'BRIEN MS OTR/L (OCCUPATIONAL THERAPIST)
(917) 721-5334
Entity
Organization
Contact information
Practice address
321 BEACH 102ND ST, ROCKAWAY PARK, NY 11694-2867
(917) 721-5334
Mailing address
321 BEACH 102ND ST, ROCKAWAY PARK, NY 11694-2867
(917) 721-5334
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
008207-1
NY
252Y00000X
Early Intervention Provider Agency
Primary
008207-1
NY
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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