Provider Demographics
NPI:1013040351
Name:RIVERA BROWN, JESSICA (OTR)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RIVERA BROWN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 PROSPECT AVE
Mailing Address - Street 2:#3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5468
Mailing Address - Country:US
Mailing Address - Phone:718-788-6757
Mailing Address - Fax:212-746-8661
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:NEW YORK PRESBYTERIAN HOSPITAL AT CORNELL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-1623
Practice Address - Fax:212-746-8661
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011075225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist