Individual provider Active NPI

Maureen Anne Killeen, OTR/L

  • Specialist
  • Ardsley, NY
National Provider Identifier
1396019600
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7674909 Issued in NY
Practice address
1053 Saw Mill River Rd
Suite 10502
Ardsley, NY 10502-1048
Phone
(914) 674-0733
NPI assigned
Mar 5, 2012
Last updated
Mar 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7674909 NY Primary

Addresses

Primary practice location

1053 Saw Mill River Rd
Suite 10502
Ardsley, NY 10502-1048

Mailing address

4 Hanford PL
Tarrytown, NY 10591-3102
Phone (914) 715-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7674909NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1396019600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HANFORD PL",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105913102",
            "telephone_number": "914-715-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 SAW MILL RIVER RD",
            "address_2": "SUITE 10502",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105021048",
            "telephone_number": "914-674-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "MAUREEN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "7674909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardsley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.