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NPI Code Detail

MEDICARE: MRS. BRENDA JEAN KOCHANOWSKI OT

MEDICARE: MRS. BRENDA JEAN KOCHANOWSKI OT
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 Therapist004584-1NY

General Provider Information

NPI Number : 1821370677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA JEAN KOCHANOWSKI OT
Provider Business Mailing Address
First Line : 15 SCHOOL ST
Second Line :
City : SHERBURNE
State : NY
Zip : 13460-9505
Country : US
Telephone Number : 607-674-7336
Fax Number :
Provider Business Practice Location Address
First Line : 15 SCHOOL ST
Second Line :
City : SHERBURNE
State : NY
Zip : 13460-9505
Country : US
Telephone Number : 607-674-7336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 09/16/2011

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