Provider Demographics
NPI:1710299011
Name:KHALOYAN, SACHA (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:SACHA
Middle Name:
Last Name:KHALOYAN
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 1:200 OLD PALISADE RD
Mailing Address - Street 2:APARTMENT 22B
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7056
Mailing Address - Country:US
Mailing Address - Phone:201-575-2134
Mailing Address - Fax:
Practice Address - Street 1:340 E 24TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4019
Practice Address - Country:US
Practice Address - Phone:212-585-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016183225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health