MEDICARE: SHANNEN KOLESAR MS, 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	023871	NY

General Provider Information

NPI Number	:	1407403876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNEN KOLESAR MS, OTR/L

Provider Business Mailing Address
First Line	:	91 MACON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-2014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 JEFFERSON BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3329
Country	:	US
Telephone Number	:	929-284-3318
Fax Number	:

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

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	12/10/2021

Similar Medicare Providers

1760628556 — DR. PALVI PATEL DPT,MA, BS
Practice Location Address:

200 JEFFERSON BLVD
STATEN ISLAND, NY
10312-3329

Practice Phone: 929-284-3318
Practice Fax:

1154813608 — NICOLE MICHELE CASSANO OTR
Practice Location Address:

200 JEFFERSON BLVD
STATEN ISLAND, NY
10312-3329

Practice Phone: 929-284-3318
Practice Fax:

1275377186 — JAIME BONURA
Practice Location Address:

200 JEFFERSON BLVD
STATEN ISLAND, NY
10312-3329

Practice Phone: 347-996-2519
Practice Fax:

1457209322 — LALITA N REYES FNP-C
Practice Location Address:

341 HILLMAN AVE
STATEN ISLAND, NY
10314-3329

Practice Phone: 917-324-0980
Practice Fax:

1003054370 — DR. RACHEL IOSPA DMD
Practice Location Address:

39 HEINZ AVE
STATEN ISLAND, NY
10308-3329

Practice Phone: 347-782-1889
Practice Fax:

1154553048 — SPEECH PATHOLOGY THERAPY (LOGOPED), INC.
Practice Location Address:

519 BUEL AVE
STATEN ISLAND, NY
10305-3329

Practice Phone: 718-987-3087
Practice Fax:

Directions to “ SHANNEN KOLESAR MS, OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.