Provider Demographics
NPI:1407627953
Name:AVERNA, KAYCE
Entity Type:Individual
Prefix:
First Name:KAYCE
Middle Name:
Last Name:AVERNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 QUINNIPIAC AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3623
Mailing Address - Country:US
Mailing Address - Phone:203-624-3303
Mailing Address - Fax:203-752-2333
Practice Address - Street 1:163 QUINNIPIAC AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3623
Practice Address - Country:US
Practice Address - Phone:203-624-3303
Practice Address - Fax:203-752-2333
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant