Provider Demographics
NPI:1609174226
Name:KILKENNY, JANET THERESA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:THERESA
Last Name:KILKENNY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MARYCREST RD
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2432
Mailing Address - Country:US
Mailing Address - Phone:845-624-1604
Mailing Address - Fax:
Practice Address - Street 1:100 KINDERKAMACK RD
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1828
Practice Address - Country:US
Practice Address - Phone:201-265-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09067900224Z00000X
NY006509-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant