Jeremiah Kane, OTR L
Individual provider Active NPI Occupational Therapist · Waverly, NY
NPI 1376749515 · NPPES record last updated Dec 3, 2007
Key facts
- NPI
- 1376749515
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 010996 (NY)
- Practice address
- 231 Weaver Rd
Waverly, NY 14892-9820 - Phone
- (607) 565-7886
- NPI assigned
- Jun 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2860 | AZ | MD | Occupational Therapist |
| 010996 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2860 | AZ | |
| Occupational Therapist | 225X00000X | 010996 | NY | Yes |
Addresses
Primary practice location
231 Weaver Rd
Waverly, NY 14892-9820
Mailing address
231 Weaver Rd
Waverly, NY 14892-9820
Other providers in Waverly, NY
- Guthrie Medical Group, P.C.
- Guthrie Specialty Physicians, PC
- Dianne L. Hill
- Victor Omamode Idahosa
- Thomas Daniel Jagger
- Nancy S. Kemp
- Saeed-Uz Zafar Khan
- Kris A Kinsley
- Kyle John Kinsley
- Juliane C Koehler
All providers in Waverly, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.