Provider Demographics
NPI:1679619399
Name:ELENKO, BETH KORBY (PHD, OTL)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:KORBY
Last Name:ELENKO
Suffix:
Gender:F
Credentials:PHD, OTL
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:ANDREA
Other - Last Name:KORBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 GEORGIA LN
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3803
Mailing Address - Country:US
Mailing Address - Phone:718-281-4470
Mailing Address - Fax:718-281-1048
Practice Address - Street 1:9 GEORGIA LN
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3803
Practice Address - Country:US
Practice Address - Phone:718-270-7737
Practice Address - Fax:718-270-7464
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006483-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics