Healthcare Provider Details

I. General information

NPI: 1215174966
Provider Name (Legal Business Name): ELLEN FURMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2009
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 COURT STR.
BROOKLYN NY
11201
US

IV. Provider business mailing address

2630 CROPSEY AVE APT 13J
BROOKLYN NY
11214-6723
US

V. Phone/Fax

Practice location:
  • Phone: 718-935-3030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number015524
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number015524
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: