Provider Demographics
NPI:1679771372
Name:PEDIATRIC OT SOLUTIONS
Entity type:Organization
Organization Name:PEDIATRIC OT SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTRL
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUBECKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:845-238-3826
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-0025
Mailing Address - Country:US
Mailing Address - Phone:845-238-3826
Mailing Address - Fax:845-238-3827
Practice Address - Street 1:615 ROUTE 32
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HIGHLAND MILLS
Practice Address - State:NY
Practice Address - Zip Code:10930-5200
Practice Address - Country:US
Practice Address - Phone:845-827-5360
Practice Address - Fax:845-827-5361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010261-1225X00000X, 225XP0200X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty