Provider Demographics
NPI:1043336100
Name:FELIX, ELAINE MARGARET (OTA)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:MARGARET
Last Name:FELIX
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MISS
Other - First Name:ELAINE
Other - Middle Name:MARGARET
Other - Last Name:ZELEZNOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA
Mailing Address - Street 1:2442 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 ELLEN MEMORIAL LN
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-4096
Practice Address - Country:US
Practice Address - Phone:570-253-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP-006043224Z00000X
NY006086-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant