Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003321555 |
---|---|
Provider Name | Yelena Svetlitskaya |
First Address | Brooklyn, NY 11211-2037 |
Second Address | Brooklyn, NY 11211-2037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2017 |
Last Update Date | 06/12/2017 |