Basic Information
| Provider Information | |||||||||
| NPI: | 1255063376 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WORK IN PROGRESS OT LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 ELM CT | ||||||||
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| City: | NORWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076482009 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 515 MADISON AVE FL 6 | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100225403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127526770 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2022 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| AuthorizedOfficialLastName: | WEINER | ||||||||
| AuthorizedOfficialFirstName: | CARLY | ||||||||
| AuthorizedOfficialMiddleName: | MICHELLE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2019833981 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OT | ||||||||
| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.