MEDICARE: MS. FAINA LEVITSKY 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	225XP0200X	Pediatric Occupational Therapist	017128	NY
2	225XP0200X	Pediatric Occupational Therapist	013792-1	NY

General Provider Information

NPI Number	:	1265623375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FAINA LEVITSKY OTR/L

Provider Business Mailing Address
First Line	:	5404 TILDEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203
Country	:	US
Telephone Number	:	718-346-6240
Fax Number	:	718-345-3083

Provider Business Practice Location Address
First Line	:	5404 TILDEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203
Country	:	US
Telephone Number	:	718-346-6240
Fax Number	:	718-345-3083

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	03/30/2012

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