Provider Demographics
NPI:1215192851
Name:AMINOV, LUIZA (OT)
Entity Type:Individual
Prefix:
First Name:LUIZA
Middle Name:
Last Name:AMINOV
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 CLYDE ST
Mailing Address - Street 2:APT 6S
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4056
Mailing Address - Country:US
Mailing Address - Phone:718-644-3321
Mailing Address - Fax:
Practice Address - Street 1:179TH STREET AND LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11425
Practice Address - Country:US
Practice Address - Phone:718-526-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist