Healthcare Provider Details

I. General information

NPI: 1568395127
Provider Name (Legal Business Name): DEEPLY ROOTED OT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3065 BRIGHTON 2ND ST # 525
BROOKLYN NY
11235-7404
US

IV. Provider business mailing address

3065 BRIGHTON 2ND ST # 525
BROOKLYN NY
11235-7404
US

V. Phone/Fax

Practice location:
  • Phone: 718-312-9020
  • Fax:
Mailing address:
  • Phone: 718-312-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AKILINA BELSKAYA
Title or Position: CEO
Credential: OT
Phone: 718-312-9020