Provider Demographics
NPI:1740565720
Name:CYPRESS, PENELOPE KNIGHT (OT)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:KNIGHT
Last Name:CYPRESS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PENELOPE
Other - Middle Name:KNIGHT
Other - Last Name:CYPRESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:7 OAK ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1819
Mailing Address - Country:US
Mailing Address - Phone:607-432-4212
Mailing Address - Fax:
Practice Address - Street 1:7 OAK ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1819
Practice Address - Country:US
Practice Address - Phone:607-432-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001756-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist