Provider Demographics
NPI:1033408570
Name:ROONEY, KATHLEEN M (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:ROONEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BOROLINE RD
Mailing Address - Street 2:REHAB DEPARTMENT
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2343
Mailing Address - Country:US
Mailing Address - Phone:201-236-0931
Mailing Address - Fax:201-236-0931
Practice Address - Street 1:5 BOROLINE RD
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2343
Practice Address - Country:US
Practice Address - Phone:201-236-0931
Practice Address - Fax:201-236-0931
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00392800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist