Provider Demographics
NPI:1811140403
Name:MCINERNEY, JUSTINE NICOLE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:NICOLE
Last Name:MCINERNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HANCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4630
Mailing Address - Country:US
Mailing Address - Phone:914-943-9598
Mailing Address - Fax:914-969-1081
Practice Address - Street 1:15 HANCOCK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4630
Practice Address - Country:US
Practice Address - Phone:914-457-5528
Practice Address - Fax:914-969-1081
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013138-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist