Provider Demographics
NPI:1962944322
Name:MUSHEYEVA, YELENA (MS OTR/L)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:MUSHEYEVA
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6361 YELLOWSTONE BLVD
Mailing Address - Street 2:APT 5S
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1577
Mailing Address - Country:US
Mailing Address - Phone:646-595-6081
Mailing Address - Fax:
Practice Address - Street 1:6361 YELLOWSTONE BLVD
Practice Address - Street 2:APT 5S
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1577
Practice Address - Country:US
Practice Address - Phone:646-595-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016494-1225X00000X, 225XG0600X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics