Organization
FAST TRACK OCCUPATIONAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA NEKHANEVICH OT (PRESIDENT)
(718) 998-3020
Entity
Organization
Contact information
Practice address
4111 18TH AVE, STE 12, BROOKLYN, NY 11218-5894
(718) 998-3020
(718) 998-9059
Mailing address
1656 E 12TH ST, BROOKLYN, NY 11229-1012
(718) 998-3020
(718) 998-3020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015491
LICENSE
NY
Enumeration date
01/17/2013
Last updated
01/17/2013
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