Provider Demographics
NPI:1740942820
Name:TOURI, NICOLE MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:TOURI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-1610
Mailing Address - Country:US
Mailing Address - Phone:203-249-2047
Mailing Address - Fax:
Practice Address - Street 1:100 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5105
Practice Address - Country:US
Practice Address - Phone:914-215-7824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025931225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist