Provider Demographics
NPI:1457505133
Name:NORDMANN, KATHRYN MAHONEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MAHONEY
Last Name:NORDMANN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3920
Mailing Address - Country:US
Mailing Address - Phone:215-962-3178
Mailing Address - Fax:
Practice Address - Street 1:12 BRYANT DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3920
Practice Address - Country:US
Practice Address - Phone:215-962-3178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012711-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics