Healthcare Provider Details

I. General information

NPI: 1982516175
Provider Name (Legal Business Name): OLGA MASHEYEV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9825 HORACE HARDING EXPY
CORONA NY
11368-4627
US

IV. Provider business mailing address

7316 172ND ST
FRESH MEADOWS NY
11366-1421
US

V. Phone/Fax

Practice location:
  • Phone: 718-271-5637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number010105
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: