Provider Demographics
NPI:1043269855
Name:KASSIMIR HAND THERAPY, OT, PLLC
Entity type:Organization
Organization Name:KASSIMIR HAND THERAPY, OT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAND THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSIMIR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:631-421-9191
Mailing Address - Street 1:2375B NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4258
Mailing Address - Country:US
Mailing Address - Phone:631-421-9191
Mailing Address - Fax:631-421-1979
Practice Address - Street 1:2375B NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4258
Practice Address - Country:US
Practice Address - Phone:631-421-9191
Practice Address - Fax:631-421-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002060-1225XH1200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQRW521Medicare PIN
NY5304130001Medicare NSC