Organization
PADMORE OCCUPATIONAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE PADMORE OTR/L (PRESIDENT)
(718) 612-6188
Entity
Organization
Contact information
Practice address
61 W GRAND ST, STE 0C, MOUNT VERNON, NY 10552-2133
(718) 612-6188
(866) 352-6711
Mailing address
61 W GRAND ST, STE 0C, MOUNT VERNON, NY 10552-2133
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
010811
NY
252Y00000X
Early Intervention Provider Agency
010811
NY
261QR0400X
Rehabilitation Clinic/Center
Primary
0108011
NY
Other
Enumeration date
09/29/2010
Last updated
01/09/2012
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