Provider Demographics
NPI:1801162573
Name:HOPE-MOORE, OSSA PRINCESS (OTR/L)
Entity type:Individual
Prefix:
First Name:OSSA
Middle Name:PRINCESS
Last Name:HOPE-MOORE
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 1:12030 227TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-2130
Mailing Address - Country:US
Mailing Address - Phone:718-949-8165
Mailing Address - Fax:
Practice Address - Street 1:20115 115TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2803
Practice Address - Country:US
Practice Address - Phone:718-465-2286
Practice Address - Fax:718-464-0040
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005848-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist