MEDICARE: MS. KERRY ANNE LENIHAN C.O.T.A

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	224Z00000X	Occupational Therapy Assistant	003070-1	NY

General Provider Information

NPI Number	:	1265702443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KERRY ANNE LENIHAN C.O.T.A

Provider Business Mailing Address
First Line	:	1232 ROUTE 17 K
Second Line	:	APARTMENT 2
City	:	MONTGOMERY
State	:	NY
Zip	:	12549-2216
Country	:	US
Telephone Number	:	845-313-7613
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 ROUTE 17 K
Second Line	:	SUITE NUMBER TWO
City	:	MONTGOMERY
State	:	NY
Zip	:	12549-2216
Country	:	US
Telephone Number	:	845-313-7613
Fax Number	:

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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