Provider Demographics
NPI:1801452487
Name:BELYANSKAYA, IRINA (OTR/L)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:BELYANSKAYA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 NEPTUNE AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6847
Mailing Address - Country:US
Mailing Address - Phone:347-492-6455
Mailing Address - Fax:347-492-6454
Practice Address - Street 1:358 NEPTUNE AVE FL 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6847
Practice Address - Country:US
Practice Address - Phone:347-492-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-19
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023589-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist