Provider Demographics
NPI:1447955356
Name:C.J. ALLEN OT UPPER EXTREMITY & HAND THERAPY, PLLC
Entity type:Organization
Organization Name:C.J. ALLEN OT UPPER EXTREMITY & HAND THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:631-761-6996
Mailing Address - Street 1:2108 JOSHUAS PATH
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4764
Mailing Address - Country:US
Mailing Address - Phone:631-761-6996
Mailing Address - Fax:631-761-6997
Practice Address - Street 1:290 E MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2916
Practice Address - Country:US
Practice Address - Phone:631-761-6996
Practice Address - Fax:631-761-6997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJ ALLEN OT UPPER EXTREMITY & HAND THERAPY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-31
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty