Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 024634 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 024634 | NY |
NPI | 1043830847 |
---|---|
Provider Name | Ilana Ariyev |
First Address | Rego Park, NY 11374-3654 |
Second Address | Rego Park, NY 11374-3654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2020 |
Last Update Date | 21/04/2020 |