Provider Demographics
NPI:1710511381
Name:KRYZHEVSKY, IRINA (OT, CHT)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:KRYZHEVSKY
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 CAPTAIN EAMES CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1982
Mailing Address - Country:US
Mailing Address - Phone:617-645-8828
Mailing Address - Fax:
Practice Address - Street 1:4 WETHERSFIELD RD # 8
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1770
Practice Address - Country:US
Practice Address - Phone:508-653-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-23
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5790225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand