Provider Demographics
NPI:1497920912
Name:ZVENYIKA, TAFARA (OT)
Entity Type:Individual
Prefix:
First Name:TAFARA
Middle Name:
Last Name:ZVENYIKA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:TAFARA
Other - Middle Name:
Other - Last Name:ZVENYIKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:181 BRIELLE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6422
Mailing Address - Country:US
Mailing Address - Phone:347-546-8804
Mailing Address - Fax:
Practice Address - Street 1:181 BRIELLE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6422
Practice Address - Country:US
Practice Address - Phone:718-370-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009804-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist