Provider Demographics
NPI:1881160646
Name:KAHAN, ZLATY (MST BCBA)
Entity type:Individual
Prefix:
First Name:ZLATY
Middle Name:
Last Name:KAHAN
Suffix:
Gender:F
Credentials:MST BCBA
Other - Prefix:
Other - First Name:ZLATY
Other - Middle Name:
Other - Last Name:SEIDENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MST, BCBA
Mailing Address - Street 1:4205 17TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1029
Mailing Address - Country:US
Mailing Address - Phone:347-675-6102
Mailing Address - Fax:
Practice Address - Street 1:4205 17TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1029
Practice Address - Country:US
Practice Address - Phone:347-675-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP13452103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst