Provider Demographics
NPI:1336772193
Name:HASLAM, NORIKA LOTOYA
Entity Type:Individual
Prefix:
First Name:NORIKA
Middle Name:LOTOYA
Last Name:HASLAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 BEL PRE RD APT 201
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2469
Mailing Address - Country:US
Mailing Address - Phone:646-474-7484
Mailing Address - Fax:
Practice Address - Street 1:293 E 53RD ST # 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3605
Practice Address - Country:US
Practice Address - Phone:646-464-5229
Practice Address - Fax:718-676-6014
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008434224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant