MEDICARE: MS. JOCELYN LIBROJO OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	007225	NY

General Provider Information

NPI Number	:	1043307457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOCELYN LIBROJO OT

Provider Business Mailing Address
First Line	:	3138 34TH STREET
Second Line	:	APT#2R
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-1739
Country	:	US
Telephone Number	:	718-204-4910
Fax Number	:	212-238-7009

Provider Business Practice Location Address
First Line	:	3138 34TH ST
Second Line	:	APT#2R
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-1739
Country	:	US
Telephone Number	:	718-204-4910
Fax Number	:	212-238-7009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/27/2010

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