Provider Demographics
NPI:1295599579
Name:MENSAH, TRACY A (OTR)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:A
Last Name:MENSAH
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 1:735 LINCOLN AVE APT 14E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4139
Mailing Address - Country:US
Mailing Address - Phone:347-265-8033
Mailing Address - Fax:
Practice Address - Street 1:735 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4172
Practice Address - Country:US
Practice Address - Phone:347-265-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027850-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist