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NPI Code Detail

MEDICARE: TATYANA KRAVTSOVA OT

MEDICARE: TATYANA KRAVTSOVA OT
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
1225X00000XOccupational Therapist020801NY

General Provider Information

NPI Number : 1265983829
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATYANA KRAVTSOVA OT
Provider Business Mailing Address
First Line : 7120 110TH ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4844
Country : US
Telephone Number : 718-305-1190
Fax Number : 718-305-1191
Provider Business Practice Location Address
First Line : 7120 110TH ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4844
Country : US
Telephone Number : 718-305-1190
Fax Number : 718-305-1191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2016
Last Update Date : 10/19/2016

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