Healthcare Provider Details

I. General information

NPI: 1154247849
Provider Name (Legal Business Name): BRIANA FERNANDEZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MADISON AVE FL 5
NEW YORK NY
10016-6796
US

IV. Provider business mailing address

1212 LORING AVE APT 1F
BROOKLYN NY
11208-5046
US

V. Phone/Fax

Practice location:
  • Phone: 646-374-8277
  • Fax:
Mailing address:
  • Phone: 347-563-4998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number031131-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: