Provider Demographics
NPI:1205067097
Name:OLAYA, NAYIBE (OT)
Entity type:Individual
Prefix:MRS
First Name:NAYIBE
Middle Name:
Last Name:OLAYA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1933
Mailing Address - Country:US
Mailing Address - Phone:516-414-7853
Mailing Address - Fax:
Practice Address - Street 1:53 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1933
Practice Address - Country:US
Practice Address - Phone:516-414-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006637-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist