Provider Demographics
NPI:1508004276
Name:CONWAY, KAREN P (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:P
Last Name:CONWAY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:PORRAZZO-CONWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 52A
Mailing Address - Street 2:1873 LIVINGSTON STREET
Mailing Address - City:LIMA
Mailing Address - State:NY
Mailing Address - Zip Code:14485-0852
Mailing Address - Country:US
Mailing Address - Phone:585-820-4029
Mailing Address - Fax:585-624-1983
Practice Address - Street 1:1873 LIVINGSTON STREET
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:NY
Practice Address - Zip Code:14485-0852
Practice Address - Country:US
Practice Address - Phone:585-820-4029
Practice Address - Fax:585-624-1983
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001868-1225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology