Provider Demographics
NPI:1033756994
Name:RICCIO, KATHRYN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:RICCIO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2631
Mailing Address - Country:US
Mailing Address - Phone:914-725-7727
Mailing Address - Fax:
Practice Address - Street 1:46 HARRISON ST
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2631
Practice Address - Country:US
Practice Address - Phone:914-364-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012553225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist