Provider Demographics
NPI:1235383720
Name:DESPORT, BRIGITTE CARIDAD (DPS, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:BRIGITTE
Middle Name:CARIDAD
Last Name:DESPORT
Suffix:
Gender:F
Credentials:DPS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 135TH ST
Mailing Address - Street 2:2S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2731
Mailing Address - Country:US
Mailing Address - Phone:917-603-2385
Mailing Address - Fax:212-368-1241
Practice Address - Street 1:300 W 135TH ST
Practice Address - Street 2:2S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2731
Practice Address - Country:US
Practice Address - Phone:917-603-2385
Practice Address - Fax:212-368-1241
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009959-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics