MEDICARE: KRISTA LOREN DENARO OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	026781	NY

General Provider Information

NPI Number	:	1164167284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA LOREN DENARO OTR/L

Provider Business Mailing Address
First Line	:	981 US HIGHWAY 22 FL 2
Second Line	:
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-2946
Country	:	US
Telephone Number	:	201-801-7141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 SOUTH AVE STE 704
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3425
Country	:	US
Telephone Number	:	718-303-9777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2022
Last Update Date	:	05/03/2022

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