Provider Demographics
NPI:1659515724
Name:MARKOVICH, ELVIRA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ELVIRA
Middle Name:
Last Name:MARKOVICH
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 1:350 W PASSAIC ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3073
Mailing Address - Country:US
Mailing Address - Phone:201-927-5638
Mailing Address - Fax:
Practice Address - Street 1:350 W PASSAIC ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3073
Practice Address - Country:US
Practice Address - Phone:201-927-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006852-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist