Provider Demographics
NPI:1568652584
Name:BUCKLEY, KAREN A (MA, OTL)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:MA, OTL
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POTENTIALS: OCCUPATIONAL THERAPY P.C.
Mailing Address - Street 2:303 MERRICK RD. SUITE 301
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563
Mailing Address - Country:US
Mailing Address - Phone:516-619-2222
Mailing Address - Fax:516-619-2224
Practice Address - Street 1:POTENTIALS: OCCUPATIONAL THERAPY P.C.
Practice Address - Street 2:303 MERRICK RD. SUITE 301
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:516-619-2222
Practice Address - Fax:516-619-2224
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001642-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics