MEDICARE: ELENA KRIKORIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist		OH

General Provider Information

NPI Number	:	1437573441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA KRIKORIAN

Provider Business Mailing Address
First Line	:	8132 CAMARGOWOODS CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-2206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6612 MIAMI AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-3143
Country	:	US
Telephone Number	:	513-561-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	12/15/2015

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