MEDICARE: MRS. MARGARET ROSE KENNEY 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	008787	NY

General Provider Information

NPI Number	:	1558611921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET ROSE KENNEY OTR/L

Provider Business Mailing Address
First Line	:	40 MARION PL
Second Line	:
City	:	PEARL RIVER
State	:	NY
Zip	:	10965-1907
Country	:	US
Telephone Number	:	845-620-3950
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 MARION PL
Second Line	:
City	:	PEARL RIVER
State	:	NY
Zip	:	10965-1907
Country	:	US
Telephone Number	:	845-620-3950
Fax Number	:

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

Provider Enumeration Date	:	09/13/2012
Last Update Date	:	09/24/2020

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