Provider Demographics
NPI:1144570920
Name:MCGOWAN, EILEEN MARY (OTR)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARY
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WILLOW PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7310
Mailing Address - Country:US
Mailing Address - Phone:914-924-9391
Mailing Address - Fax:
Practice Address - Street 1:1031 ELM ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3401
Practice Address - Country:US
Practice Address - Phone:914-737-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007174-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist