Provider Demographics
NPI:1982973228
Name:LENIHAN, KRISTEN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:LENIHAN
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 1:163 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-2150
Mailing Address - Country:US
Mailing Address - Phone:631-567-5582
Mailing Address - Fax:
Practice Address - Street 1:163 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-2150
Practice Address - Country:US
Practice Address - Phone:631-567-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00739172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker