Provider Demographics
NPI:1689950313
Name:MEREDITH, KENDALL (OTR)
Entity Type:Individual
Prefix:MS
First Name:KENDALL
Middle Name:
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ST JOSEPHS TER
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-2513
Mailing Address - Country:US
Mailing Address - Phone:518-434-3342
Mailing Address - Fax:
Practice Address - Street 1:360 STATE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1910
Practice Address - Country:US
Practice Address - Phone:518-828-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2691225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist