Provider Demographics
NPI:1417183021
Name:WERDE, CHANA Z (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:Z
Last Name:WERDE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 NEW YORK AVE
Mailing Address - Street 2:6B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4280
Mailing Address - Country:US
Mailing Address - Phone:917-861-5128
Mailing Address - Fax:
Practice Address - Street 1:502 NEW YORK AVE
Practice Address - Street 2:6B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4280
Practice Address - Country:US
Practice Address - Phone:917-861-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63 014671225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist