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General NPI Number Information
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NPI Number | 1487988275
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Entity Type | Individual
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Provider Name | LYUDNILA LEAH MUNAROVA B.A., B.S., M.A., OT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | BIRCH LONG ISLAND EARLY CHILDHOOD CENTER 10-24 49TH AVE
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101
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Country | US
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Telephone | 718-786-1104
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Fax |
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Provider Business Mailing Address
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Address Line | 64-60 AUSTIN ST
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 646-267-2818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 0150501
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License Number State | NY
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