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General NPI Number Information
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NPI Number | 1003725540
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Entity Type | Organization
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Legal Business Name | ELEVATE REHABILITATE OT PLLC
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 16 KENT PL
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City | AMITYVILLE
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State | NY
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Zip | 11701-4035
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Country | US
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Telephone | 347-271-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 16 KENT PL
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City | AMITYVILLE
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State | NY
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Zip | 11701-4035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ OCCUPATIONAL THERAPIST
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Name | SHANIQUE ST FLEUR
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Credential | OTR/L
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Telephone | 347-271-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number |
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License Number State |
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