Provider Demographics
NPI:1154363356
Name:MILNER SVETLANA OCCUPATIONAL THERAPY PC
Entity type:Organization
Organization Name:MILNER SVETLANA OCCUPATIONAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:718-380-4750
Mailing Address - Street 1:15611 AGUILAR AVE
Mailing Address - Street 2:PR1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2732
Mailing Address - Country:US
Mailing Address - Phone:718-380-4750
Mailing Address - Fax:
Practice Address - Street 1:15611 AGUILAR AVE
Practice Address - Street 2:PR1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2731
Practice Address - Country:US
Practice Address - Phone:718-380-4750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02405549Medicaid
NY05880Medicare PIN
NYQTW021Medicare PIN