Provider Demographics
NPI:1356833545
Name:CARTLEDGE, KRISTEN ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:CARTLEDGE
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 1:6 TANAGER RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1030
Mailing Address - Country:US
Mailing Address - Phone:845-519-0971
Mailing Address - Fax:
Practice Address - Street 1:6 TANAGER RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1030
Practice Address - Country:US
Practice Address - Phone:845-519-0971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022401-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00096023OtherCDPHP