Provider Demographics
NPI:1750651287
Name:BRACERO, JEMIMA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JEMIMA
Middle Name:
Last Name:BRACERO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JEMIMA
Other - Middle Name:
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1049 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1012
Mailing Address - Country:US
Mailing Address - Phone:718-633-6666
Mailing Address - Fax:718-633-5331
Practice Address - Street 1:1049 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1012
Practice Address - Country:US
Practice Address - Phone:718-633-6666
Practice Address - Fax:718-633-5331
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015727225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics