Provider Demographics
NPI:1053741843
Name:HAND REHABILITATION OF SUFFOLK
Entity type:Organization
Organization Name:HAND REHABILITATION OF SUFFOLK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:631-893-1957
Mailing Address - Street 1:400 W MAIN ST
Mailing Address - Street 2:STE109
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3012
Mailing Address - Country:US
Mailing Address - Phone:631-893-1957
Mailing Address - Fax:631-893-1958
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:STE109
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3012
Practice Address - Country:US
Practice Address - Phone:631-893-1957
Practice Address - Fax:631-893-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0030011225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0030011OtherLICENSE