MEDICARE: KAILEY WILLIAMS 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	030585-01	NY

General Provider Information

NPI Number	:	1427925718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAILEY WILLIAMS OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 1104
Second Line	:
City	:	PINE BUSH
State	:	NY
Zip	:	12566-1104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 WINDSOR HWY STE 210
Second Line	:
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-6286
Country	:	US
Telephone Number	:	845-764-0785
Fax Number	:

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

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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