Provider Demographics
NPI:1689288698
Name:HANLON, KIMBERLY EILEEN
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:EILEEN
Last Name:HANLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 KINCAID DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1604
Mailing Address - Country:US
Mailing Address - Phone:914-380-2752
Mailing Address - Fax:
Practice Address - Street 1:24 KINCAID DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1604
Practice Address - Country:US
Practice Address - Phone:914-380-2752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist