Provider Demographics
NPI:1053943480
Name:WOLFF, CHAVIVA L (OT)
Entity type:Individual
Prefix:DR
First Name:CHAVIVA
Middle Name:L
Last Name:WOLFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:DR
Other - First Name:A
Other - Middle Name:L
Other - Last Name:WOLFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:376 WILLARD RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4629
Mailing Address - Country:US
Mailing Address - Phone:201-262-0356
Mailing Address - Fax:
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4823
Practice Address - Country:US
Practice Address - Phone:212-606-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006715225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty