Individual provider Active NPI

Olga Khazanova, OTR

  • Pediatric Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1669614566
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
014497 Issued in NY
Practice address
2554 Harway Ave FL 2
Brooklyn, NY 11214-6623
Phone
(718) 372-4586
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 014497 NY Primary

Addresses

Primary practice location

2554 Harway Ave FL 2
Brooklyn, NY 11214-6623

Mailing address

2554 Harway Ave FL 2
Brooklyn, NY 11214-6623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014497NYMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1669614566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 HARWAY AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 HARWAY AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146623",
            "telephone_number": "718-372-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZANOVA",
        "first_name": "OLGA",
        "name_prefix": "Miss",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "014497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.