Provider Demographics
NPI:1467712729
Name:AULOV, DIANA (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:AULOV
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 1:10525 65TH AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1802
Mailing Address - Country:US
Mailing Address - Phone:347-551-1665
Mailing Address - Fax:
Practice Address - Street 1:10525 65TH AVE APT 4B
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1802
Practice Address - Country:US
Practice Address - Phone:347-551-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017378225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics