Provider Demographics
NPI:1700122751
Name:KRAVETZ, RACHEL NEMZER (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:NEMZER
Last Name:KRAVETZ
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 1:17-11 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2149
Mailing Address - Country:US
Mailing Address - Phone:917-868-1363
Mailing Address - Fax:
Practice Address - Street 1:685 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:RIVER VALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-6335
Practice Address - Country:US
Practice Address - Phone:201-497-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00657600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist