Provider Demographics
NPI:1528548997
Name:ROSS, KATHRYN MEG (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MEG
Last Name:ROSS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 21ST ST APT 1018
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3228
Mailing Address - Country:US
Mailing Address - Phone:516-316-1090
Mailing Address - Fax:
Practice Address - Street 1:120 W 21ST ST APT 1018
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3228
Practice Address - Country:US
Practice Address - Phone:516-316-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022367225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics