Provider Demographics
NPI:1477001030
Name:LYUBEZHANINA, ZHANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ZHANNA
Middle Name:
Last Name:LYUBEZHANINA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 KERBER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-4365
Mailing Address - Country:US
Mailing Address - Phone:315-941-2718
Mailing Address - Fax:
Practice Address - Street 1:216 KERBER RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-4365
Practice Address - Country:US
Practice Address - Phone:315-941-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117814225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist