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General NPI Number Information
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NPI Number | 1962731596
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Entity Type | Individual
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Provider Name | SHANNON PAGE KRAUS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 151 E 67TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-5964
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Country | US
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Telephone | 212-988-9500
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Fax | 212-570-6690
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Provider Business Mailing Address
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Address Line | PO BOX 34
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City | VERMONTVILLE
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State | NY
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Zip | 12989-0034
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Country | US
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Telephone | 917-715-9639
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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 | 015935
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License Number State | NY
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