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NPI Code Detail

MEDICARE: KELLEY BERNS OTR

MEDICARE:   KELLEY  BERNS  OTR
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
1225X00000XOccupational Therapist1314WV
2225X00000XOccupational Therapist5440OH

General Provider Information

NPI Number : 1326163379
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY BERNS OTR
Provider Business Mailing Address
First Line : 1 BERWYN DR
Second Line :
City : OCEAN VIEW
State : NJ
Zip : 08230-1462
Country : US
Telephone Number : 609-545-8620
Fax Number :
Provider Business Practice Location Address
First Line : 1 BERWYN DR
Second Line :
City : OCEAN VIEW
State : NJ
Zip : 08230-1462
Country : US
Telephone Number : 609-545-8620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 05/22/2015

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Directions to “ KELLEY BERNS OTR” Practice Location

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