Provider Demographics
NPI:1487222402
Name:RUBIN, CHAVA B (COTA/L, BS)
Entity type:Individual
Prefix:
First Name:CHAVA
Middle Name:B
Last Name:RUBIN
Suffix:
Gender:F
Credentials:COTA/L, BS
Other - Prefix:
Other - First Name:CHAVA
Other - Middle Name:B
Other - Last Name:KAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L , BS
Mailing Address - Street 1:47 CHELSEA RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2646
Mailing Address - Country:US
Mailing Address - Phone:845-825-4191
Mailing Address - Fax:
Practice Address - Street 1:47 CHELSEA RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2646
Practice Address - Country:US
Practice Address - Phone:845-825-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09123400224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant