Provider Demographics
NPI:1023625936
Name:ZAETZ, CHAYA R (MS SPECIAL EDUCATION)
Entity type:Individual
Prefix:
First Name:CHAYA
Middle Name:R
Last Name:ZAETZ
Suffix:
Gender:F
Credentials:MS SPECIAL EDUCATION
Other - Prefix:
Other - First Name:CHAYA
Other - Middle Name:R
Other - Last Name:ZAETZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:706 EASTERN PKWY APT 6I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3408
Mailing Address - Country:US
Mailing Address - Phone:347-416-0662
Mailing Address - Fax:
Practice Address - Street 1:797 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1312
Practice Address - Country:US
Practice Address - Phone:347-416-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No252Y00000XAgenciesEarly Intervention Provider Agency