Nikolay Nisimov, COTA
Individual provider Active NPI Occupational Therapy Assistant · Long Beach, CA
NPI 1285075937 · NPPES record last updated Jul 10, 2013
Key facts
- NPI
- 1285075937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- Practice address
- 330 Golden SHR
Long Beach, CA 90802-4246 - Phone
- (866) 985-5008
- NPI assigned
- Jul 10, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Yes |
Addresses
Primary practice location
330 Golden SHR
Long Beach, CA 90802-4246
Mailing address
855 S Wooster St
Los Angeles, CA 90035-1772
Other providers in Long Beach, CA
- Yusuke Ninomiya
- Visal Nip
- Kyle F Nishimura
- Alicia Naomi Nishioka
- Craig Nishioka
- Kim Edward Nissen
- Christopher Paul Nitollama
- Cindy Ugochi Njemanze
- Lloyd U Njoku
- Theresa Njoku
All providers in Long Beach, CA · Occupational Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.