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NPI Code Detail

MEDICARE: LIBBY DANIELLE KERSHNER OTR

MEDICARE: LIBBY DANIELLE KERSHNER 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 Therapist016842NY

General Provider Information

NPI Number : 1639467392
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIBBY DANIELLE KERSHNER OTR
Provider Business Mailing Address
First Line : 8842 STATE ROUTE 90 N
Second Line :
City : KING FERRY
State : NY
Zip : 13081-8717
Country : US
Telephone Number : 315-364-7570
Fax Number : 315-364-8016
Provider Business Practice Location Address
First Line : 8842 STATE ROUTE 90 N
Second Line :
City : KING FERRY
State : NY
Zip : 13081-8717
Country : US
Telephone Number : 315-364-7570
Fax Number : 315-364-8016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2011
Last Update Date : 07/15/2011

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Directions to “ LIBBY DANIELLE KERSHNER OTR” Practice Location

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