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General NPI Number Information
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NPI Number | 1962063974
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Entity Type | Individual
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Provider Name | HIROMI KENNY
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 3004 146TH ST
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City | FLUSHING
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State | NY
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Zip | 11354-2324
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Country | US
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Telephone | 718-445-1575
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Fax |
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Provider Business Mailing Address
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Address Line | 4708 196TH ST
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City | FLUSHING
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State | NY
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Zip | 11358-3935
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Country | US
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Telephone | 646-263-4003
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010148
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License Number State | NY
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