Provider Demographics
NPI:1851327928
Name:MARKHASIN, YURIY (OT)
Entity Type:Individual
Prefix:MR
First Name:YURIY
Middle Name:
Last Name:MARKHASIN
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 BRIGHTON 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5502
Mailing Address - Country:US
Mailing Address - Phone:917-586-8680
Mailing Address - Fax:
Practice Address - Street 1:3042 BRIGHTON 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5502
Practice Address - Country:US
Practice Address - Phone:917-586-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400000402OtherGHI MEDICARE