Patrick McKenna, OTR

Individual provider Active NPI Occupational Therapist · East Quogue, NY

NPI 1831341601 · NPPES record last updated Dec 17, 2020

Key facts

NPI
1831341601
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2435 (CT)
Practice address
143 Chardonnay Dr
East Quogue, NY 11942-3829
Phone
(631) 278-0665
Fax
(203) 651-1877
NPI assigned
Oct 10, 2008
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

LicenseStateTypeSpecialty
002435CTMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 002435 CT
Occupational Therapist 225X00000X 2435 CT Yes

Addresses

Primary practice location

143 Chardonnay Dr
East Quogue, NY 11942-3829

Mailing address

143 Chardonnay Dr
East Quogue, NY 11942-3829
Phone (631) 278-0665

Other providers in East Quogue, NY

All providers in East Quogue, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.