Provider Demographics
NPI:1225669294
Name:BLEICH, KHRYSTSINA
Entity Type:Individual
Prefix:MISS
First Name:KHRYSTSINA
Middle Name:
Last Name:BLEICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 68TH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-6324
Mailing Address - Country:US
Mailing Address - Phone:646-986-7874
Mailing Address - Fax:
Practice Address - Street 1:285 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1006
Practice Address - Country:US
Practice Address - Phone:718-935-9201
Practice Address - Fax:718-797-2892
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist