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NPI Code Detail

MEDICARE: MRS. KELLY L MONACO OTR

MEDICARE: MRS. KELLY L MONACO 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
1225X00000XOccupational Therapist017281-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518233865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY L MONACO OTR
Provider Business Mailing Address
First Line : 19 ROBINSON RD # 1000
Second Line :
City : CLINTON
State : NY
Zip : 13323-1418
Country : US
Telephone Number : 315-853-6090
Fax Number :
Provider Business Practice Location Address
First Line : 19 ROBINSON RD
Second Line :
City : CLINTON
State : NY
Zip : 13323-1418
Country : US
Telephone Number : 315-853-6090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2012
Last Update Date : 12/16/2022

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Directions to “ MRS. KELLY L MONACO OTR” Practice Location

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