Provider Demographics
NPI:1023253812
Name:ALLEN, TANIKA S (OTA)
Entity type:Individual
Prefix:
First Name:TANIKA
Middle Name:S
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SCHENECTADY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-4240
Mailing Address - Country:US
Mailing Address - Phone:347-901-1200
Mailing Address - Fax:
Practice Address - Street 1:1221 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-3301
Practice Address - Country:US
Practice Address - Phone:718-538-8343
Practice Address - Fax:718-538-8356
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006361 DUP224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant