Provider Demographics
NPI:1336359967
Name:FLOR-SANCHEZ, ELIZABETH FLOR (COTA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:FLOR
Last Name:FLOR-SANCHEZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-1426
Mailing Address - Country:US
Mailing Address - Phone:631-728-7823
Mailing Address - Fax:
Practice Address - Street 1:188 W MONTAUK HWY STE E6
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2363
Practice Address - Country:US
Practice Address - Phone:631-728-7875
Practice Address - Fax:631-728-8204
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002130-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant