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NPI Code Detail

MEDICARE: EMILY REBECCA HAGEMANN MS, OTR

MEDICARE: EMILY REBECCA HAGEMANN MS, 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 Therapist

General Provider Information

NPI Number : 1427631423
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY REBECCA HAGEMANN MS, OTR
Provider Business Mailing Address
First Line : 4018 HAMPTON ST APT 3J
Second Line :
City : ELMHURST
State : NY
Zip : 11373-2056
Country : US
Telephone Number : 631-513-9989
Fax Number :
Provider Business Practice Location Address
First Line : 2420 PARSONS BLVD
Second Line :
City : WHITESTONE
State : NY
Zip : 11357-3444
Country : US
Telephone Number : 718-459-6279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2021
Last Update Date : 04/28/2021

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