Provider Demographics
NPI:1508336934
Name:CHANALES, SHIFRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHIFRA
Middle Name:
Last Name:CHANALES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHIFRA
Other - Middle Name:
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:14753 72ND DR APT 2F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3177 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-4905
Practice Address - Country:US
Practice Address - Phone:718-696-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist