Provider Demographics
NPI:1487993770
Name:KALICHMAN, CARA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:
Last Name:KALICHMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 67TH AVE APT 5J
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2440
Mailing Address - Country:US
Mailing Address - Phone:201-264-1971
Mailing Address - Fax:
Practice Address - Street 1:10230 67TH AVE APT 5J
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2440
Practice Address - Country:US
Practice Address - Phone:201-264-1971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017416-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist