Provider Demographics
NPI:1922464932
Name:ALPANO, JENALYN ABALOS (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JENALYN
Middle Name:ABALOS
Last Name:ALPANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 LABAU AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4243
Mailing Address - Country:US
Mailing Address - Phone:917-403-6573
Mailing Address - Fax:
Practice Address - Street 1:774 MANOR RD
Practice Address - Street 2:SUITE 210
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-7038
Practice Address - Country:US
Practice Address - Phone:718-983-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017675225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist