Healthcare Provider Details

I. General information

NPI: 1649879867
Provider Name (Legal Business Name): ROCHEL KAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 38TH ST
BROOKLYN NY
11218-3612
US

IV. Provider business mailing address

533 DAHILL RD APT 2
BROOKLYN NY
11218-3964
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-3700
  • Fax:
Mailing address:
  • Phone: 718-757-0342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: