Organization
ELLAS OT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELINA RAFAILOVA OT (OWNER)
(718) 219-9535
Entity
Organization
Contact information
Practice address
53 BAY 25TH ST FL 2, BROOKLYN, NY 11214-3903
(718) 219-9535
Mailing address
53 BAY 25TH ST FL 2, BROOKLYN, NY 11214-3903
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020284-1
LICENSE
NY
Enumeration date
01/31/2019
Last updated
01/31/2019
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