MEDICARE: ANN HEFFERON KILCARR

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	225100000X	Physical Therapist	015546-1	NY

General Provider Information

NPI Number	:	1528193356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN HEFFERON KILCARR

Provider Business Mailing Address
First Line	:	158 ASPEN ST
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11001-3432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1999 MARCUS AVE STE M15
Second Line	:
City	:	NORTH NEW HYDE PARK
State	:	NY
Zip	:	11042-1023
Country	:	US
Telephone Number	:	516-488-8808
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	02/14/2020

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Directions to “ ANN HEFFERON KILCARR ” Practice Location

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