Provider Demographics
NPI:1154687325
Name:COOPER, TIFFANY KATHERINA (MS,OTR/L)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:KATHERINA
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-6851
Mailing Address - Country:US
Mailing Address - Phone:212-477-1735
Mailing Address - Fax:212-477-2396
Practice Address - Street 1:600 E 6TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-6851
Practice Address - Country:US
Practice Address - Phone:212-477-1735
Practice Address - Fax:212-477-2396
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015306-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics