MEDICARE: MRS. ILANA SABBAGH MS OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	12869	FL
2	225XP0200X	Pediatric Occupational Therapist	12869	FL

General Provider Information

NPI Number	:	1053506410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ILANA SABBAGH MS OTR/L

Provider Business Mailing Address
First Line	:	363 WEST WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561
Country	:	US
Telephone Number	:	305-890-4626
Fax Number	:

Provider Business Practice Location Address
First Line	:	363 W WALNUT ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3216
Country	:	US
Telephone Number	:	305-890-4626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	08/28/2013

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