Provider Demographics
NPI:1275787178
Name:GUY, TRICIA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:K
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:852 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2731
Mailing Address - Country:US
Mailing Address - Phone:347-381-9005
Mailing Address - Fax:
Practice Address - Street 1:852 E 34TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2731
Practice Address - Country:US
Practice Address - Phone:347-381-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY013530-1OtherLICENSE#