Provider Demographics
NPI:1255887758
Name:ALLAYEV, ILANA (MS OTR/L)
Entity type:Individual
Prefix:MS
First Name:ILANA
Middle Name:
Last Name:ALLAYEV
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 102ND ST
Mailing Address - Street 2:APT 7S
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2453
Mailing Address - Country:US
Mailing Address - Phone:347-456-4624
Mailing Address - Fax:
Practice Address - Street 1:6715 102ND ST
Practice Address - Street 2:APT 7S
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2453
Practice Address - Country:US
Practice Address - Phone:347-456-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020410-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist