Provider Demographics
NPI:1376944280
Name:KERSHNER, EMILY GRACE (MS, OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:GRACE
Last Name:KERSHNER
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 1:5 THE TRADEWINDS APT D
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2147
Mailing Address - Country:US
Mailing Address - Phone:716-698-9530
Mailing Address - Fax:
Practice Address - Street 1:5 THE TRADEWINDS APT D
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14221-2147
Practice Address - Country:US
Practice Address - Phone:716-698-9530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019155225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist