Provider Demographics
NPI:1265077895
Name:ELIZABETH ANN CAROLAN OT PLLC
Entity type:Organization
Organization Name:ELIZABETH ANN CAROLAN OT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CAROLAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL, MHS
Authorized Official - Phone:516-297-2331
Mailing Address - Street 1:600 FULTON ST APT R1
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3535
Mailing Address - Country:US
Mailing Address - Phone:516-297-2331
Mailing Address - Fax:516-843-7606
Practice Address - Street 1:600 FULTON ST APT R1
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3535
Practice Address - Country:US
Practice Address - Phone:516-297-2331
Practice Address - Fax:516-843-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health