Provider Demographics
NPI:1356541239
Name:KREBS, ELAINE S (MA, OTR)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:S
Last Name:KREBS
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SEAVIEW LN
Mailing Address - Street 2:PORT WASHINGTON
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1737
Mailing Address - Country:US
Mailing Address - Phone:516-883-6633
Mailing Address - Fax:516-883-6633
Practice Address - Street 1:25 SEAVIEW LANE
Practice Address - Street 2:PORT WASHINGTON
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:11050-1737
Practice Address - Country:US
Practice Address - Phone:516-883-6633
Practice Address - Fax:516-883-6633
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001397-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics