Organization
CAMACHO'S PURPOSEFUL OCCUPATIONAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY CAMACHO OTR/L (PRESIDENT)
(917) 679-9546
Entity
Organization
Contact information
Practice address
1121 ASHLEY DR, VALLEY STREAM, NY 11580-2431
(917) 679-9546
Mailing address
1121 ASHLEY DR, VALLEY STREAM, NY 11580-2431
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
016784
NY
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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