Provider Demographics
NPI:1336640754
Name:VETRANO, HOLLY C (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:C
Last Name:VETRANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:C
Other - Last Name:INCALCATERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:30 LANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-2827
Mailing Address - Country:US
Mailing Address - Phone:631-987-9501
Mailing Address - Fax:
Practice Address - Street 1:30 LANDVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:KING PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-2827
Practice Address - Country:US
Practice Address - Phone:631-987-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018204-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist