Provider Demographics
NPI:1932861606
Name:NARKOLAYEV, RAVITAL ESTER (OTR/L)
Entity Type:Individual
Prefix:
First Name:RAVITAL
Middle Name:ESTER
Last Name:NARKOLAYEV
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 1:15102 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2504
Mailing Address - Country:US
Mailing Address - Phone:917-373-4309
Mailing Address - Fax:
Practice Address - Street 1:2447 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5915
Practice Address - Country:US
Practice Address - Phone:718-882-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025963-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist