Kristina Boutchatski, OTR/L
Individual provider Active NPI Rehabilitation Hospital · Brooklin, NY
NPI 1730389727 · NPPES record last updated Oct 27, 2007
Key facts
- NPI
- 1730389727
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Hospital 283X00000X
- License
- 014370 (NY)
- Practice address
- 264 72ND St
1A
Brooklin, NY 11209 - Phone
- (646) 209-7043
- NPI assigned
- Jul 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | |||
| Rehabilitation Hospital | 283X00000X | 014370 | NY | Yes |
Addresses
Primary practice location
264 72ND St
1A
Brooklin, NY 11209
Mailing address
264 72ND St Apt 1a
Brooklyn, NY 11209-2151
Phone (646) 209-7043
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.