Doctor Name: | KELLY HANNON |
NPI Number: | 1447313242 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTR |
License Number: | 009353-1 |
Business Practice Address: | 1607 Route 300 Suite 102 Newburgh, NY - 125501738 |
Business Phone Number: | 8455649853 |
Business Fax Number: | 8455646974 |
Mailing Address: | 1607 Route 300, Suite 102 NEWBURGH |
State: | NY |
Postal Code: | 125501738 |
Phone Number: | 8455649853 |
Fax Number: | 8455646974 |
NPI Enumeration Date: | 12/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 009353-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |