Provider Demographics
NPI:1235375304
Name:MCIVOR, KAREN ANNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANNE
Last Name:MCIVOR
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 1:21 FOXCROFT DR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1212
Mailing Address - Country:US
Mailing Address - Phone:845-627-5313
Mailing Address - Fax:845-627-5313
Practice Address - Street 1:25 TAMMY RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1337
Practice Address - Country:US
Practice Address - Phone:845-596-4974
Practice Address - Fax:845-627-5313
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005336-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics