Kyle L Mahoney, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

013055 Issued in NY

Practice address

67 Kendall St
420 Clifton Springs Professional Park
Clifton Springs, NY 14432-9701

Phone

(315) 462-2569

Fax

(315) 462-2370

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1154356749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LIBERTY CMNS",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562064",
            "telephone_number": "315-789-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 KENDALL ST",
            "address_2": "420 CLIFTON SPRINGS PROFESSIONAL PARK",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144329701",
            "telephone_number": "315-462-2569",
            "fax_number": "315-462-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KYLE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11334525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiran Luther, MD
• Briana Lyon
• Robert Lewis Macomber, PA
• Ingrid Carolina Madero, MD
• Kristin Lee Mahoney, OTR/L CLT
• Andrea Maier
• Karen Lynne Maloney, RNFA
• Kelly Ann Maloney
• Sylvia Todd Manly, RPH
• Stacy A Marotta, NP

• Occupational Therapist in Clifton Springs, NY
• Providers in Clifton Springs, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.