MEDICARE: MRS. JUSTINE NICOLE MCINERNEY 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	013138-1	NY

General Provider Information

NPI Number	:	1811140403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUSTINE NICOLE MCINERNEY OTR/L

Provider Business Mailing Address
First Line	:	15 HANCOCK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10705-4630
Country	:	US
Telephone Number	:	914-943-9598
Fax Number	:	914-969-1081

Provider Business Practice Location Address
First Line	:	15 HANCOCK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10705-4630
Country	:	US
Telephone Number	:	914-457-5528
Fax Number	:	914-969-1081

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	06/01/2010

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Directions to “ MRS. JUSTINE NICOLE MCINERNEY OTR/L” Practice Location

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