Provider Demographics
NPI:1720314040
Name:HARPAZ, YELENA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:HARPAZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 122ND ST
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3232
Mailing Address - Country:US
Mailing Address - Phone:718-504-2355
Mailing Address - Fax:
Practice Address - Street 1:333 BROADWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:AMYTIVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-789-1900
Practice Address - Fax:631-789-1985
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031350-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist