MEDICARE: KYLEE JAYNE KOHRN 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	225XP0200X	Pediatric Occupational Therapist
2	225X00000X	Occupational Therapist	027186-01	NY

General Provider Information

NPI Number	:	1588380943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLEE JAYNE KOHRN OTR/L

Provider Business Mailing Address
First Line	:	72 MARKLEY DR
Second Line	:
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1279
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	72 MARKLEY DR
Second Line	:
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1279
Country	:	US
Telephone Number	:	716-262-5346
Fax Number	:

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	12/10/2025

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