MEDICARE: LEON KIRSCHNER OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	01872-0	NY

General Provider Information

NPI Number	:	1265657886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEON KIRSCHNER OTR

Provider Business Mailing Address
First Line	:	7711 35TH AVE
Second Line	:	APARTMENT 4J
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-4659
Country	:	US
Telephone Number	:	718-478-7544
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1915
Country	:	US
Telephone Number	:	718-430-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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