Healthcare Provider Details

I. General information

NPI: 1841523198
Provider Name (Legal Business Name): IRENE ZOMBEK M.S. OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000A EXPRESSWAY DR S
HOLBROOK NY
11741-1827
US

IV. Provider business mailing address

5000A EXPRESSWAY DR S
HOLBROOK NY
11741-1827
US

V. Phone/Fax

Practice location:
  • Phone: 646-436-6535
  • Fax:
Mailing address:
  • Phone: 646-436-6535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number006930-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number006930-1
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: