Provider Demographics
NPI:1225802358
Name:MKN OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:MKN OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAZAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KATANOV-NEKTALOV
Authorized Official - Suffix:
Authorized Official - Credentials:OTR-L
Authorized Official - Phone:646-577-8008
Mailing Address - Street 1:8273 164TH PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1824
Mailing Address - Country:US
Mailing Address - Phone:646-577-8008
Mailing Address - Fax:
Practice Address - Street 1:8273 164TH PL
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1824
Practice Address - Country:US
Practice Address - Phone:646-577-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty