Provider Demographics
NPI:1982833018
Name:THOMPSON-ALLEYNE, MARTESHA ANN (OTA)
Entity Type:Individual
Prefix:
First Name:MARTESHA
Middle Name:ANN
Last Name:THOMPSON-ALLEYNE
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12130 133RD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2913
Mailing Address - Country:US
Mailing Address - Phone:718-843-0775
Mailing Address - Fax:
Practice Address - Street 1:12130 133RD ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2913
Practice Address - Country:US
Practice Address - Phone:718-843-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004464224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant