# ORIGINS INTEGRATIVE OCCUPATIONAL THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Life Lifters Health Occupational Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639944705
- **Authorized official:** MR. MATTHEW F ROSENBOOM OTR/L (CEO)
- **Authorized official phone:** (631) 252-8167

## Contact information

- **Practice address:** 21343 35TH AVE FL 2, BAYSIDE, NY 11361-1750
- **Practice address phone:** (631) 252-8167
- **Mailing address:** 111 NEW YORK AVE, SOUND BEACH, NY 11789-2250
- **Mailing address phone:** (631) 252-8167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 11/20/2023