Provider Demographics
NPI:1497729966
Name:KLIGERMAN, BECKY
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:KLIGERMAN
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 1:52 VAN SCHOICK AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2313
Mailing Address - Country:US
Mailing Address - Phone:518-482-4466
Mailing Address - Fax:
Practice Address - Street 1:52 VAN SCHOICK AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2313
Practice Address - Country:US
Practice Address - Phone:518-482-4466
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004258-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist