Provider Demographics
NPI:1063690667
Name:KARIYEV, ZLATA (OTRL)
Entity type:Individual
Prefix:MS
First Name:ZLATA
Middle Name:
Last Name:KARIYEV
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10856 66 AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-440-5902
Mailing Address - Fax:718-459-3311
Practice Address - Street 1:8811 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2039
Practice Address - Country:US
Practice Address - Phone:718-846-2300
Practice Address - Fax:718-846-2333
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014839225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist