Provider Demographics
NPI:1396016663
Name:KANE, DENISE T (COTA / L)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:T
Last Name:KANE
Suffix:
Gender:F
Credentials:COTA / 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 FOLTIM WAY
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1421
Mailing Address - Country:US
Mailing Address - Phone:845-267-2670
Mailing Address - Fax:
Practice Address - Street 1:62 OLD MIDDLETOWN RD.
Practice Address - Street 2:CLARKSTOWN CENTRAL SCHOOL DISTRICT
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-639-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001098-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist