Provider Demographics
NPI:1760791842
Name:MOONEY, NANCY JOYCE (OT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOYCE
Last Name:MOONEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-6001
Mailing Address - Country:US
Mailing Address - Phone:718-365-7238
Mailing Address - Fax:
Practice Address - Street 1:2340 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6001
Practice Address - Country:US
Practice Address - Phone:718-365-7238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009434-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist