Provider Demographics
NPI:1861636706
Name:ASHEROVA, TATYANA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TATYANA
Middle Name:
Last Name:ASHEROVA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11516 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1415
Mailing Address - Country:US
Mailing Address - Phone:718-300-1902
Mailing Address - Fax:
Practice Address - Street 1:11516 84TH AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1415
Practice Address - Country:US
Practice Address - Phone:718-300-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007275174400000X
NY016761-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist