Provider Demographics
NPI:1831601046
Name:YAFA OT, P.C.
Entity type:Organization
Organization Name:YAFA OT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YAFA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ISKHAKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:347-798-3873
Mailing Address - Street 1:9931 64TH AVE APT D7
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2605
Mailing Address - Country:US
Mailing Address - Phone:347-798-3873
Mailing Address - Fax:
Practice Address - Street 1:9931 64TH AVE APT D7
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2605
Practice Address - Country:US
Practice Address - Phone:347-798-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019992-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency