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General NPI Number Information
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NPI Number | 1801162573
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Entity Type | Individual
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Provider Name | OSSA PRINCESS HOPE-MOORE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 20115 115TH AVE
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City | SAINT ALBANS
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State | NY
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Zip | 11412-2803
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Country | US
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Telephone | 718-465-2286
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Fax | 718-464-0040
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Provider Business Mailing Address
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Address Line | 12030 227TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-2130
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Country | US
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Telephone | 718-949-8165
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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 | 005848-1
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License Number State | NY
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