Provider Demographics
NPI:1710603139
Name:VOLYNSKY, ALEXANDER (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:VOLYNSKY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:ALEXANDER
Other - Middle Name:
Other - Last Name:VOLYNSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 W END AVE APT 3W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4880
Mailing Address - Country:US
Mailing Address - Phone:646-701-1129
Mailing Address - Fax:
Practice Address - Street 1:2 W END AVE APT 3W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4880
Practice Address - Country:US
Practice Address - Phone:646-701-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011209224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant