Provider Demographics
NPI:1366775876
Name:KRIKORIAN, EMILY E (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:E
Last Name:KRIKORIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1502
Mailing Address - Country:US
Mailing Address - Phone:516-993-5146
Mailing Address - Fax:
Practice Address - Street 1:29 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1502
Practice Address - Country:US
Practice Address - Phone:516-993-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist