Individual
ELANA PEARL LAVENDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
480 W 187TH ST APT 4H, NEW YORK, NY 10033-1506
(646) 330-4654
Mailing address
480 W 187TH ST APT 4H, NEW YORK, NY 10033-1506
(646) 330-4654
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
014023-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
014023-1
NY
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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