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NPI Code Detail

MEDICARE: MR. KEVIN MICHAEL HELLER MS, OTR/L

MEDICARE: MR. KEVIN MICHAEL HELLER 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
1225X00000XOccupational Therapist017028NY

General Provider Information

NPI Number : 1447555248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN MICHAEL HELLER MS, OTR/L
Provider Business Mailing Address
First Line : 5 DAKOTA DR
Second Line : SUITE 200
City : NEW HYDE PARK
State : NY
Zip : 11042-1107
Country : US
Telephone Number : 516-729-4301
Fax Number :
Provider Business Practice Location Address
First Line : 5 DAKOTA DR
Second Line : SUITE 200
City : NEW HYDE PARK
State : NY
Zip : 11042-1107
Country : US
Telephone Number : 516-729-4301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2011
Last Update Date : 03/03/2013

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