Provider Demographics
NPI:1073068169
Name:CAROLAN, ELIZABETH ANN (MHS OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:CAROLAN
Suffix:
Gender:F
Credentials:MHS OTR/L
Other - Prefix:
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Mailing Address - Street 1:600 FULTON ST
Mailing Address - Street 2:APT R1
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3540
Mailing Address - Country:US
Mailing Address - Phone:516-297-2331
Mailing Address - Fax:516-843-7606
Practice Address - Street 1:600 FULTON ST
Practice Address - Street 2:APT R1
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3540
Practice Address - Country:US
Practice Address - Phone:516-297-2331
Practice Address - Fax:516-843-7606
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist