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NPI Code Detail

MEDICARE: KRISTINA DANILEVICA OTA

MEDICARE: KRISTINA DANILEVICA OTA
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
1224Z00000XOccupational Therapy Assistant007491-1NY

General Provider Information

NPI Number : 1609195056
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA DANILEVICA OTA
Provider Business Mailing Address
First Line : 2606 E 15TH ST
Second Line : 202
City : BROOKLYN
State : NY
Zip : 11235-3828
Country : US
Telephone Number : 718-332-0080
Fax Number : 718-332-3365
Provider Business Practice Location Address
First Line : 2606 E 15TH ST
Second Line : 202
City : BROOKLYN
State : NY
Zip : 11235-3828
Country : US
Telephone Number : 718-332-0080
Fax Number : 718-332-3365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2010
Last Update Date : 05/25/2010

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Directions to “ KRISTINA DANILEVICA OTA” Practice Location

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