Provider Demographics
NPI:1508177536
Name:AYUB, USMAN (OT)
Entity Type:Individual
Prefix:
First Name:USMAN
Middle Name:
Last Name:AYUB
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 E 2ND ST
Mailing Address - Street 2:APT 2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5525
Mailing Address - Country:US
Mailing Address - Phone:646-732-9985
Mailing Address - Fax:
Practice Address - Street 1:51 SAINT EDWARDS ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2932
Practice Address - Country:US
Practice Address - Phone:718-855-6838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63015691225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist