Healthcare Provider Details

I. General information

NPI: 1558505388
Provider Name (Legal Business Name): HELGA FAKHERI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E 21ST ST
BROOKLYN NY
11210-5049
US

IV. Provider business mailing address

1551 E 21ST ST
BROOKLYN NY
11210-5049
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-3438
  • Fax:
Mailing address:
  • Phone: 718-951-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number013492-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: