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NPI Code Detail

MEDICARE: MS. STELLA BABAKHANOVA

MEDICARE: MS. STELLA BABAKHANOVA
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
1225XP0200XPediatric Occupational Therapist014380-1NY

General Provider Information

NPI Number : 1760619043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STELLA BABAKHANOVA
Provider Business Mailing Address
First Line : 8515 139TH ST
Second Line : 7I
City : BRIARWOOD
State : NY
Zip : 11435-2637
Country : US
Telephone Number : 718-490-6785
Fax Number : 718-899-9061
Provider Business Practice Location Address
First Line : 8403 57TH AVE
Second Line :
City : ELMHURST
State : NY
Zip : 11373-4833
Country : US
Telephone Number : 718-899-9060
Fax Number : 718-899-9061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2009
Last Update Date : 06/15/2009

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