Provider Demographics
NPI:1962937714
Name:SHAULOV, NAOMI (OTR)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:
Last Name:SHAULOV
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147-29 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3123
Mailing Address - Country:US
Mailing Address - Phone:347-820-0707
Mailing Address - Fax:
Practice Address - Street 1:147-29 77TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3123
Practice Address - Country:US
Practice Address - Phone:347-820-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist