Provider Demographics
NPI:1538300629
Name:HALPERT, JESSICA SAMARA I (OT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:SAMARA
Last Name:HALPERT
Suffix:I
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:SAMARA
Other - Last Name:PITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9306 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7005
Mailing Address - Country:US
Mailing Address - Phone:718-238-7451
Mailing Address - Fax:
Practice Address - Street 1:9306 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7005
Practice Address - Country:US
Practice Address - Phone:718-238-7451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0013271-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics