Provider Demographics
NPI:1831779925
Name:RISING STARS THERAPY LLC
Entity type:Organization
Organization Name:RISING STARS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TSIPPORA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDERGRUN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:646-937-0644
Mailing Address - Street 1:6112 STUART AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4022
Mailing Address - Country:US
Mailing Address - Phone:646-937-0644
Mailing Address - Fax:
Practice Address - Street 1:6112 STUART AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4022
Practice Address - Country:US
Practice Address - Phone:646-937-0644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty