MEDICARE: JOAO PEDRO NERY OTR/L

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	225X00000X	Occupational Therapist	025930	NY

General Provider Information

NPI Number	:	1396461877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAO PEDRO NERY OTR/L

Provider Business Mailing Address
First Line	:	427 WINTER ST
Second Line	:
City	:	FRAMINGHAM
State	:	MA
Zip	:	01702-5669
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 E SPRUCE ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5672
Country	:	US
Telephone Number	:	508-308-9219
Fax Number	:

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

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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