Provider Demographics
NPI:1508172347
Name:BUCHANAN, KEVIN PAUL (MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:PAUL
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:52 WILDWAY
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-5918
Mailing Address - Country:US
Mailing Address - Phone:914-819-2578
Mailing Address - Fax:
Practice Address - Street 1:4915 ASPEN HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3709
Practice Address - Country:US
Practice Address - Phone:301-933-3451
Practice Address - Fax:013-933-0350
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07513225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics