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General NPI Number Information
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NPI Number | 1942840517
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Entity Type | Individual
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Provider Name | EILEEN MARIE KELLEHER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 25 RICHMOND PL
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-1642
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Country | US
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Telephone | 914-447-9575
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RICHMOND PL
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-1642
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Country | US
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Telephone | 914-447-9575
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTH-007811
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License Number State | AZ
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