PAIGE KATHERINE TYSON MS OTR/L, PC
Agencies at Shore Rd, Brooklyn, NY

License number
New York 010332
Category
Agencies
Type
Home Health
Owner
Name: MS. PAIGE KATHERINE TYSON MS OTR/L
Title: PRESIDENT
Phone: (718) 680-5610
Address
Address
9977 Shore Rd APT 11D, Brooklyn, NY 11209
National Provider ID: 1730332172
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PAIGE KATHERINE TYSON, MS, OTR/L, PC

8212 3 Ave, Brooklyn, NY 11209

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
Dissolution
Registration:
May 3, 2007
Inactive since:
Feb 24, 2012
Phone:
(347) 782-6482 (Phone)
State ID:
3512304
Business type:
DOMESTIC PROFESSIONAL CORPORATION
President:
Paige K Tyson (President), 8212 3 Ave, Brooklyn, NY 11209 (Physical)
Agent:
Lawrence P. Giardina Esq,8212 3 Ave, Brooklyn, NY 11209 (Physical)

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