Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 12869 | FL |
N | 225XP0200X | Occupational Therapist - Pediatrics | 12869 | FL |
NPI | 1053506410 |
---|---|
Provider Name | Mrs. Ilana Sabbagh |
First Address | Long Beach, NY 11561 |
Second Address | Long Beach, NY 11561-3216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 28/08/2013 |