Provider Demographics
NPI:1558632349
Name:BEY, LAKEISHA (OTR)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:
Last Name:BEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 153RD AVE
Mailing Address - Street 2:APT 1M
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1957
Mailing Address - Country:US
Mailing Address - Phone:917-601-3926
Mailing Address - Fax:
Practice Address - Street 1:8439 153RD AVE
Practice Address - Street 2:APT 1M
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1957
Practice Address - Country:US
Practice Address - Phone:917-601-3926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007766225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist