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General NPI Number Information
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NPI Number | 1558738815
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Entity Type | Individual
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Provider Name | JESSICA BISHOP MSOT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 675 3RD AVE 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017-5704
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Country | US
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Telephone | 212-871-0621
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PINETREE LN
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-2301
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Country | US
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Telephone | 609-489-3004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | TR651400
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License Number State | NJ
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