Provider Demographics
NPI:1740302678
Name:VICOY, AIMEE (OTR)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:
Last Name:VICOY
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 1:9016 179TH PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5611
Mailing Address - Country:US
Mailing Address - Phone:646-464-4949
Mailing Address - Fax:
Practice Address - Street 1:9016 179TH PL
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5611
Practice Address - Country:US
Practice Address - Phone:646-464-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014278225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist