Laura Sullivan, OTR/L

Individual provider Active NPI Occupational Therapist · Wilton, NY

NPI 1164833232 · NPPES record last updated Apr 21, 2022

Key facts

NPI
1164833232
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
018288-1 (NY)
Practice address
30 Sheffield Rd
Wilton, NY 12831-1494
Phone
(646) 825-1722
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
018288-1NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Play Move Grow Occupational Therapy PLLC Occupational Therapist Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 018288-1 NY Yes

Addresses

Primary practice location

30 Sheffield Rd
Wilton, NY 12831-1494

Mailing address

30 Sheffield Rd
Wilton, NY 12831-1494
Phone (646) 825-1722

Other providers in Wilton, NY

All providers in Wilton, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.