Provider Demographics
NPI:1982970489
Name:NORAT, TAYISHA
Entity Type:Individual
Prefix:
First Name:TAYISHA
Middle Name:
Last Name:NORAT
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 1:1535 STORY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4555
Mailing Address - Country:US
Mailing Address - Phone:718-842-2655
Mailing Address - Fax:718-328-5506
Practice Address - Street 1:1535 STORY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4555
Practice Address - Country:US
Practice Address - Phone:718-842-2655
Practice Address - Fax:718-328-5506
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010122-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist