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NPI Code Detail

MEDICARE: KRISTEN MULONE O.T.

MEDICARE: KRISTEN MULONE O.T.
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 Therapist012079NY

General Provider Information

NPI Number : 1861892721
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN MULONE O.T.
Provider Business Mailing Address
First Line : 20 PEACHTREE CT
Second Line : SUITE 105
City : HOLBROOK
State : NY
Zip : 11741-4616
Country : US
Telephone Number : 631-467-3700
Fax Number : 631-467-0928
Provider Business Practice Location Address
First Line : 6363 TRANSIT RD
Second Line :
City : EAST AMHERST
State : NY
Zip : 14051-2716
Country : US
Telephone Number : 716-688-5709
Fax Number : 716-688-5709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2014
Last Update Date : 08/28/2014

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