Provider Demographics
NPI:1275848467
Name:SHEVCHUK, EKATERINA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:SHEVCHUK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2020
Mailing Address - Country:US
Mailing Address - Phone:201-394-6350
Mailing Address - Fax:
Practice Address - Street 1:2501 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2020
Practice Address - Country:US
Practice Address - Phone:201-394-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016458-1225XP0200X
NJ46TR00826500225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics