MEDICARE: MRS. YULIYA ROYBERMAN 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	019703	NY

General Provider Information

NPI Number	:	1073973137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULIYA ROYBERMAN OTR/L

Provider Business Mailing Address
First Line	:	2411 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6041
Country	:	US
Telephone Number	:	718-909-5929
Fax Number	:	718-942-5753

Provider Business Practice Location Address
First Line	:	2411 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6041
Country	:	US
Telephone Number	:	718-395-3155
Fax Number	:	718-395-3141

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

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	03/08/2022

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