Provider Demographics
NPI:1811212525
Name:GALENO, KATHLEEN BERNADETTE (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:BERNADETTE
Last Name:GALENO
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114-20 ROCKAWAY BLVD.
Mailing Address - Street 2:QUEENSBORO OCCUPATIONAL THERAPY
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420
Mailing Address - Country:US
Mailing Address - Phone:718-845-4616
Mailing Address - Fax:718-845-1965
Practice Address - Street 1:114-20 ROCKAWAY BLVD
Practice Address - Street 2:QUEENSBORO OCCUPATIONAL THERAPY
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420
Practice Address - Country:US
Practice Address - Phone:718-845-4616
Practice Address - Fax:718-845-1965
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008992-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist