Provider Demographics
NPI:1811225741
Name:ADALSHA, YASMIN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:YASMIN
Middle Name:
Last Name:ADALSHA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7751
Mailing Address - Country:US
Mailing Address - Phone:646-423-5738
Mailing Address - Fax:212-644-2582
Practice Address - Street 1:301 E 62ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7751
Practice Address - Country:US
Practice Address - Phone:646-423-5738
Practice Address - Fax:212-644-2582
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003072-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant