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NPI Code Detail

MEDICARE: KATHLEEN SCANLON OTR/L

MEDICARE: KATHLEEN SCANLON 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
1225XP0200XPediatric Occupational Therapist031076-01NY

General Provider Information

NPI Number : 1821931288
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN SCANLON OTR/L
Provider Business Mailing Address
First Line : 669 BROADWAY
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-2314
Country : US
Telephone Number : 516-799-2900
Fax Number : 516-799-2928
Provider Business Practice Location Address
First Line : 669 BROADWAY
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-2314
Country : US
Telephone Number : 516-799-2900
Fax Number : 516-799-2928
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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