Provider Demographics
NPI:1255753588
Name:INTEGRITY CARE OCCUPATIONAL THERAPY PC
Entity type:Organization
Organization Name:INTEGRITY CARE OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GENKIN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:347-248-1245
Mailing Address - Street 1:303 AVENUE P APT F9
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4129
Mailing Address - Country:US
Mailing Address - Phone:347-248-1245
Mailing Address - Fax:
Practice Address - Street 1:401 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4919
Practice Address - Country:US
Practice Address - Phone:347-248-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty