Provider Demographics
NPI:1043307457
Name:LIBROJO, JOCELYN (OT)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:
Last Name:LIBROJO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 34TH STREET
Mailing Address - Street 2:APT#2R
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1739
Mailing Address - Country:US
Mailing Address - Phone:718-204-4910
Mailing Address - Fax:212-238-7009
Practice Address - Street 1:3138 34TH ST
Practice Address - Street 2:APT#2R
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-1739
Practice Address - Country:US
Practice Address - Phone:718-204-4910
Practice Address - Fax:212-238-7009
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ199320801Medicare PIN