Provider Demographics
NPI:1184346165
Name:KRASNEY, KAITLYN JULIA
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:JULIA
Last Name:KRASNEY
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 1:497 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NY
Mailing Address - Zip Code:12431-5945
Mailing Address - Country:US
Mailing Address - Phone:518-817-5043
Mailing Address - Fax:
Practice Address - Street 1:60 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3103
Practice Address - Country:US
Practice Address - Phone:518-426-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP117514225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics