Provider Demographics
NPI:1902055791
Name:YELLINEK, ANDREA L (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:L
Last Name:YELLINEK
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3452
Mailing Address - Country:US
Mailing Address - Phone:646-423-6440
Mailing Address - Fax:
Practice Address - Street 1:7524 BELL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3452
Practice Address - Country:US
Practice Address - Phone:646-423-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006827-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency