Provider Demographics
NPI:1215572565
Name:ZELARAYAN, NEWELL (OTR/L)
Entity Type:Individual
Prefix:
First Name:NEWELL
Middle Name:
Last Name:ZELARAYAN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 85TH ST APT 404
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3257
Mailing Address - Country:US
Mailing Address - Phone:347-453-3189
Mailing Address - Fax:
Practice Address - Street 1:2109 85TH ST APT 404
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3257
Practice Address - Country:US
Practice Address - Phone:347-453-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist