Mikayla O'Connor
Individual provider Active NPI Physical Therapy Assistant · Tupper Lake, NY
NPI 1891552972 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1891552972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 010521 (NY)
- Practice address
- 114 Wawbeek Ave
Tupper Lake, NY 12986-2038 - Phone
- (518) 359-8864
- NPI assigned
- Mar 5, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 010521 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 010521 | NY | Yes |
Addresses
Primary practice location
114 Wawbeek Ave
Tupper Lake, NY 12986-2038
Mailing address
35 Murray St
Tupper Lake, NY 12986-1105
Other providers in Tupper Lake, NY
- Arthur V Morey
- Lisa E Morin
- Annmarie Munn
- Jacob Nashett
- Lisa M O' Connor
- Mary C Radimer
- Susan Reandeau
- Rehab Resources
- Lori A Richardson
- Rite Aid of New York Inc
All providers in Tupper Lake, NY · Physical Therapy Assistant 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 Mar 5, 2024. 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.