Organization
FAIRBRIDGE OT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE GRANT OTR/L (PRESIDENT)
(917) 478-7388
Entity
Organization
Contact information
Practice address
222 MOTHER GASTON BLVD, BROOKLYN, NY 11233-4312
(917) 478-7388
(718) 385-2591
Mailing address
222 MOTHER GASTON BLVD, BROOKLYN, NY 11233-4312
(917) 478-7388
(718) 385-2591
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
014480
NY
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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