Provider Demographics
NPI:1447405410
Name:NAKAMURA, KAORI (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KAORI
Middle Name:
Last Name:NAKAMURA
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 1:38 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:CROSS RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10518-1309
Mailing Address - Country:US
Mailing Address - Phone:914-523-5180
Mailing Address - Fax:
Practice Address - Street 1:21 BLOOMINGDALE RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1504
Practice Address - Country:US
Practice Address - Phone:914-997-5527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008709225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist