Provider Demographics
NPI:1447383914
Name:FEDERICO, OLIVIA HUNG (OTR)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:HUNG
Last Name:FEDERICO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206-11 EMILY RD., 3RD FLR.
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1182
Mailing Address - Country:US
Mailing Address - Phone:917-601-1123
Mailing Address - Fax:718-454-4637
Practice Address - Street 1:206-11 EMILY RD., 3RD FLR.
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1182
Practice Address - Country:US
Practice Address - Phone:917-601-1123
Practice Address - Fax:718-454-4637
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008826-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist