Basic Information
| Provider Information | |||||||||
| NPI: | 1447620620 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILD'S PLAY OCCUPATIONAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1695 ALLEN GLEN RD | ||||||||
| Address2: | |||||||||
| City: | OWEGO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138273433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077257420 | ||||||||
| FaxNumber: | 6076874249 | ||||||||
| Practice Location | |||||||||
| Address1: | 1277 TAYLOR RD | ||||||||
| Address2: | |||||||||
| City: | OWEGO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138271274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077257420 | ||||||||
| FaxNumber: | 6076874249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2015 | ||||||||
| LastUpdateDate: | 10/01/2015 | ||||||||
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| AuthorizedOfficialLastName: | MCNALLY | ||||||||
| AuthorizedOfficialFirstName: | MEGHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/ OCCUPATIONAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6077257420 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | 005170 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.