Liza Kate Boland, OTR
Individual provider Active NPI Pediatric Occupational Therapist · Hawthorne, NY
NPI 1730453820 · NPPES record last updated Feb 17, 2015
Key facts
- NPI
- 1730453820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- 017521 (NY)
- Practice address
- 1 Skyline Dr
Suite 298
Hawthorne, NY 10532-2157 - Phone
- (914) 347-5990
- Fax
- (914) 347-5236
- NPI assigned
- Mar 7, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017521 | NY | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidabilities LLC | Pediatrics | Past | Accepting new patients |
| Kidabilities, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 017521 | NY | Yes |
Addresses
Primary practice location
1 Skyline Dr
Suite 298
Hawthorne, NY 10532-2157
Mailing address
1 Skyline Dr
Suite 298
Hawthorne, NY 10532-2157
Phone (914) 347-5990
Other providers in Hawthorne, NY
- Biomed Pharmaceuticals, Inc
- Jennifer Ann Black
- Ellen Blaufox
- Ilyse Blazar
- Maryam Bojarian
- Janet Borra
- Joanne Mary Bortone
- Boston Children'S Health Physicians, LLP
- Melissa Boston
- Howard E Bostwick
All providers in Hawthorne, NY · Pediatric 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 Feb 17, 2015. 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.