Provider Demographics
NPI:1073766127
Name:PATTEN, KERRY (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:
Last Name:PATTEN
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 1:10 BEDFORD CT
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3532
Mailing Address - Country:US
Mailing Address - Phone:516-398-4350
Mailing Address - Fax:516-804-8502
Practice Address - Street 1:4 FERN PL
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4725
Practice Address - Country:US
Practice Address - Phone:516-933-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011695-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics