Healthcare Provider Details

I. General information

NPI: 1609723394
Provider Name (Legal Business Name): ASHLEY KERWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 S SCHODACK RD
CASTLETON NY
12033-9644
US

IV. Provider business mailing address

275 BAUER RD
AVERILL PARK NY
12018-4509
US

V. Phone/Fax

Practice location:
  • Phone: 518-477-7103
  • Fax: 518-477-7167
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number63-P141269-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: