Provider Demographics
NPI:1033537246
Name:ICE, KATHIANNE GLASHEEN (MS)
Entity Type:Individual
Prefix:
First Name:KATHIANNE
Middle Name:GLASHEEN
Last Name:ICE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 OAKLAND BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3332
Mailing Address - Country:US
Mailing Address - Phone:914-921-5605
Mailing Address - Fax:
Practice Address - Street 1:367 OAKLAND BEACH AVE
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3332
Practice Address - Country:US
Practice Address - Phone:914-921-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018742225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist