Provider Demographics
NPI:1245562164
Name:MOISE, GUISSY (MA,OTR/L)
Entity Type:Individual
Prefix:
First Name:GUISSY
Middle Name:
Last Name:MOISE
Suffix:
Gender:F
Credentials:MA,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 E 51ST ST APT 2H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2214
Mailing Address - Country:US
Mailing Address - Phone:917-658-1519
Mailing Address - Fax:
Practice Address - Street 1:1270 E 51ST ST APT 2H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2214
Practice Address - Country:US
Practice Address - Phone:917-658-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0141911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist