Provider Demographics
NPI:1588387245
Name:MOYNIHAN, ALLISON ANN (OTR)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ANN
Last Name:MOYNIHAN
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 1:123 E 6TH RD
Mailing Address - Street 2:
Mailing Address - City:BROAD CHANNEL
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1004
Mailing Address - Country:US
Mailing Address - Phone:646-895-0310
Mailing Address - Fax:
Practice Address - Street 1:123 E 6TH RD
Practice Address - Street 2:
Practice Address - City:BROAD CHANNEL
Practice Address - State:NY
Practice Address - Zip Code:11693-1004
Practice Address - Country:US
Practice Address - Phone:646-895-0310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist