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General NPI Number Information
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NPI Number | 1720362825
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Entity Type | Individual
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Provider Name | BREANNE E KEARNEY M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 20 CEDAR ST STE 302
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5247
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Country | US
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Telephone | 914-576-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 19 BRENDAN AVE
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-3305
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Country | US
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Telephone | 516-884-0743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 017014
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License Number State | NY
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