Provider Demographics
NPI:1386281244
Name:KEALY, DANNIELLE
Entity type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:
Last Name:KEALY
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 1:183 DEVON FARMS RD
Mailing Address - Street 2:
Mailing Address - City:STORMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12582-5269
Mailing Address - Country:US
Mailing Address - Phone:203-843-3339
Mailing Address - Fax:
Practice Address - Street 1:183 DEVON FARMS RD
Practice Address - Street 2:
Practice Address - City:STORMVILLE
Practice Address - State:NY
Practice Address - Zip Code:12582-5269
Practice Address - Country:US
Practice Address - Phone:203-843-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist