Provider Demographics
NPI:1023254745
Name:KAHAN OT SERVICES
Entity type:Organization
Organization Name:KAHAN OT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TZVI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:718-797-2235
Mailing Address - Street 1:616 BEDFORD AVE
Mailing Address - Street 2:SUITE B1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-9610
Mailing Address - Country:US
Mailing Address - Phone:718-797-2235
Mailing Address - Fax:718-797-3401
Practice Address - Street 1:616 BEDFORD AVE
Practice Address - Street 2:SUITE B1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-9610
Practice Address - Country:US
Practice Address - Phone:718-797-2235
Practice Address - Fax:718-797-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011800-1302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization