Healthcare Provider Details

I. General information

NPI: 1265175657
Provider Name (Legal Business Name): CHRISTINA ERNST OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 57TH AVE
ELMHURST NY
11373-4833
US

IV. Provider business mailing address

9731 134TH AVE
OZONE PARK NY
11417-2531
US

V. Phone/Fax

Practice location:
  • Phone: 718-899-9060
  • Fax:
Mailing address:
  • Phone: 347-241-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number024518
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number024518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: