Basic Information
| Provider Information | |||||||||
| NPI: | 1902934904 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAND THERAPY OF GREATER BINGHAMTON OCCUPATIONAL THERAPY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 174 OAKDALE RD | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137901049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077290044 | ||||||||
| FaxNumber: | 6077299994 | ||||||||
| Practice Location | |||||||||
| Address1: | 174 OAKDALE RD | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137901049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077290044 | ||||||||
| FaxNumber: | 6077299994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 03/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | MONBORNE | ||||||||
| AuthorizedOfficialFirstName: | MARGARET | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6077290044 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BS OCCUPATIONAL THER | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 006302 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.