Provider Demographics
NPI:1497386445
Name:AKTER, KHALEDA
Entity Type:Individual
Prefix:
First Name:KHALEDA
Middle Name:
Last Name:AKTER
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 1:14725 88TH AVE APT 5F
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3417
Mailing Address - Country:US
Mailing Address - Phone:917-378-8592
Mailing Address - Fax:
Practice Address - Street 1:14725 88TH AVE APT 5F
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3417
Practice Address - Country:US
Practice Address - Phone:917-378-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010435224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant