| Big Strides Wide Reach Ot, Pt Pllc | |
|
11940 Metropolitan Ave Suite 105 Kew Gardens NY 11415-2600 | |
| (718) 880-1911 | |
| (718) 487-3425 |
| Full Name | Big Strides Wide Reach Ot, Pt Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11940 Metropolitan Ave, Kew Gardens, New York |
| Authorized Official Name and Position | Charmaine Morcilla (PT/MANAGING PARTNER) |
| Authorized Official Contact | 7188801911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Strides Wide Reach Ot, Pt Pllc 11940 Metropolitan Ave Suite 105 Kew Gardens NY 11415-2600 Ph: (718) 880-1911 | Big Strides Wide Reach Ot, Pt Pllc 11940 Metropolitan Ave Suite 105 Kew Gardens NY 11415-2600 Ph: (718) 880-1911 |
| NPI Number | 1992102388 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 12/01/2014 |
| Medicare PECOS PAC ID | 4082964820 |
|---|---|
| Medicare Enrollment ID | O20180829001309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992102388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Moira G Caringal |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649505132 PECOS PAC ID: 0941340491 Enrollment ID: I20091215000224 |
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