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General NPI Number Information
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NPI Number | 1912848557
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Entity Type | Individual
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Provider Name | DMITRIY KACHANOV
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Gender | Male
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 253 CORBIN PL
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City | BROOKLYN
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State | NY
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Zip | 11235-4901
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Country | US
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Telephone | 347-464-9439
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Fax |
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Provider Business Mailing Address
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Address Line | 2477 WEST ST FL 1
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City | BROOKLYN
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State | NY
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Zip | 11223-5917
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Country | US
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Telephone | 347-722-4157
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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