Provider Demographics
NPI:1801448683
Name:KORY, EVA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:KORY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:GUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:167 PARKVIEW LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1668
Mailing Address - Country:US
Mailing Address - Phone:347-902-4626
Mailing Address - Fax:
Practice Address - Street 1:167 PARKVIEW LOOP
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1668
Practice Address - Country:US
Practice Address - Phone:347-902-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty