Provider Demographics
NPI:1841632726
Name:REICH-CHEN, KAILA (OTR)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:REICH-CHEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KAILA
Other - Middle Name:
Other - Last Name:REICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1 BASKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2540
Mailing Address - Country:US
Mailing Address - Phone:732-671-5866
Mailing Address - Fax:
Practice Address - Street 1:520 BLOOMINGDALE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2061
Practice Address - Country:US
Practice Address - Phone:908-327-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054540-1104100000X, 1041S0200X
NY003430-1225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist