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General NPI Number Information
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NPI Number | 1558905232
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Entity Type | Individual
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Provider Name | MRS. OLGA TSYMBALENKO
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Gender | Female
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2504 S CORAL TRACE CIR
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3612
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Country | US
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Telephone | 646-400-1466
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Fax |
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Provider Business Mailing Address
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Address Line | 2291 E 3RD ST FL 1
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City | BROOKLYN
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State | NY
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Zip | 11223-5137
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Country | US
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Telephone | 646-400-1466
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010030
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA19225
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License Number State | FL
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