Provider Demographics
NPI:1942660253
Name:KOHN, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KOHN
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 1:1414 E 12TH ST
Mailing Address - Street 2:APT 5K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6659
Mailing Address - Country:US
Mailing Address - Phone:347-623-3729
Mailing Address - Fax:
Practice Address - Street 1:1414 E 12TH ST
Practice Address - Street 2:APT 5K
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6659
Practice Address - Country:US
Practice Address - Phone:347-623-3729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020372225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist