Provider Demographics
NPI:1699911388
Name:POJE, KELLY ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:POJE
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 1:22 WAYMAN DR
Mailing Address - Street 2:
Mailing Address - City:OTEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13825-2126
Mailing Address - Country:US
Mailing Address - Phone:607-988-6628
Mailing Address - Fax:
Practice Address - Street 1:22 WAYMAN DR
Practice Address - Street 2:
Practice Address - City:OTEGO
Practice Address - State:NY
Practice Address - Zip Code:13825-2126
Practice Address - Country:US
Practice Address - Phone:607-988-6628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008230-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics