Healthcare Provider Details

I. General information

NPI: 1720153265
Provider Name (Legal Business Name): ELANA MICHELLE SCHWARTZ OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

110 BENNETT AVE APT 2F
NEW YORK NY
10033-2308
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6262
  • Fax:
Mailing address:
  • Phone: 917-836-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number012727-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: