Basic Information
Provider Information
NPI: 1417581356
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABADI
FirstName: LIANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2840 JACKSON AVE APT 5L
Address2:  
City: LONG ISLAND CITY
State: NY
PostalCode: 111013336
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1468 MADISON AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100296508
CountryCode: US
TelephoneNumber: 2122416500
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/01/2020
LastUpdateDate: 03/01/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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