Provider Demographics
NPI:1760857338
Name:RAYKHMAN, SVETLANA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:RAYKHMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:SVETLANA
Other - Middle Name:
Other - Last Name:RAYKHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3808
Mailing Address - Country:US
Mailing Address - Phone:732-598-5495
Mailing Address - Fax:
Practice Address - Street 1:26 SANFORD ST
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3808
Practice Address - Country:US
Practice Address - Phone:732-598-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00312700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist