Healthcare Provider Details

I. General information

NPI: 1437540499
Provider Name (Legal Business Name): ABILITY O.T.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RADCLIFF RD
STATEN ISLAND NY
10305-2610
US

IV. Provider business mailing address

2 RADCLIFF RD
STATEN ISLAND NY
10305-4022
US

V. Phone/Fax

Practice location:
  • Phone: 917-406-0825
  • Fax:
Mailing address:
  • Phone: 917-406-0825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number014995-1
License Number StateNY

VIII. Authorized Official

Name: MRS. SVETLANA ARONOV
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 917-406-0825