Organization
SVR PEDIATRIC OT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN JEAN VON ROSK OTR (OCCUPATIONAL THERAPIST)
(516) 798-8501
Entity
Organization
Contact information
Practice address
126 BALTIMORE AVE, MASSAPEQUA, NY 11758-4124
(516) 798-8501
Mailing address
126 BALTIMORE AVE., MASSAPEQUA, NY 11758
(516) 798-8501
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
006486
NY
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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