Provider Demographics
NPI:1215623210
Name:ASAAD, HEBA A (COTA)
Entity type:Individual
Prefix:MRS
First Name:HEBA
Middle Name:A
Last Name:ASAAD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 68TH AVE # L
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2835
Mailing Address - Country:US
Mailing Address - Phone:929-395-2760
Mailing Address - Fax:
Practice Address - Street 1:7840 68TH AVE # L
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2835
Practice Address - Country:US
Practice Address - Phone:929-395-2760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY485399224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant