Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 025712-01 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 025712-01 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 025712-01 | NY |
NPI | 1558038422 |
---|---|
Provider Name | Elina Yakobov |
First Address | Rego Park, NY 11374-4634 |
Second Address | Rego Park, NY 11374-4634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2021 |
Last Update Date | 26/08/2021 |