Provider Demographics
NPI:1558905232
Name:TSYMBALENKO, OLGA
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:
Last Name:TSYMBALENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 E 3RD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5137
Mailing Address - Country:US
Mailing Address - Phone:646-400-1466
Mailing Address - Fax:
Practice Address - Street 1:2504 S CORAL TRACE CIR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3612
Practice Address - Country:US
Practice Address - Phone:646-400-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010030224Z00000X
FLOTA19225224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant