Provider Demographics
NPI:1457658635
Name:OCCUPATIONAL THERAPY SOLUTIONS, PC
Entity Type:Organization
Organization Name:OCCUPATIONAL THERAPY SOLUTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYUBOV
Authorized Official - Middle Name:
Authorized Official - Last Name:SERVAKH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:917-330-6321
Mailing Address - Street 1:2114 E 24TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4902
Mailing Address - Country:US
Mailing Address - Phone:917-330-6321
Mailing Address - Fax:
Practice Address - Street 1:2114 E 24TH ST APT 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4902
Practice Address - Country:US
Practice Address - Phone:917-330-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015567-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1992949713OtherINDIVIDUAL NPI