Provider Demographics
NPI:1073231908
Name:MUSA, RUWAIDA (OTR)
Entity Type:Individual
Prefix:
First Name:RUWAIDA
Middle Name:
Last Name:MUSA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:RUBY
Other - Middle Name:
Other - Last Name:LABARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150 COLGATE AVE APT IC
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3137
Mailing Address - Country:US
Mailing Address - Phone:347-220-9622
Mailing Address - Fax:
Practice Address - Street 1:1150 COLGATE AVE APT IC
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3137
Practice Address - Country:US
Practice Address - Phone:347-220-9622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026605225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty