Provider Demographics
NPI:1053681700
Name:KIERNAN, EILEEN MARGARET (OTR/L)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARGARET
Last Name:KIERNAN
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 1:39 STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4207
Mailing Address - Country:US
Mailing Address - Phone:914-391-1422
Mailing Address - Fax:
Practice Address - Street 1:47 CROYDEN ROAD
Practice Address - Street 2:SCHOOL 29
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710
Practice Address - Country:US
Practice Address - Phone:914-376-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009549225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist