Provider Demographics
NPI:1982839577
Name:KHAIT, GELENA (OTR/L)
Entity Type:Individual
Prefix:
First Name:GELENA
Middle Name:
Last Name:KHAIT
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 1:8700 25TH AVE APT 7O
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5437
Mailing Address - Country:US
Mailing Address - Phone:917-951-1615
Mailing Address - Fax:
Practice Address - Street 1:8700 25TH AVE APT 7O
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5437
Practice Address - Country:US
Practice Address - Phone:917-951-1615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014939225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03153124Medicaid
NY03153124Medicaid