Individual
MS. ELAINA ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
907 SYCAMORE AVENUE, BOHEMIA, NY 11716
(631) 786-7532
Mailing address
907 SYCAMORE AVE, BOHEMIA, NY 11716-3516
(631) 786-7532
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
015357-1
NY
Other
Enumeration date
09/22/2009
Last updated
03/24/2015
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