Individual
ENMANUEL MOISES ANTONIO BENCOSME ALEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1051 RIVERSIDE DR, NEW YORK, NY 10032-1007
(646) 774-5000
Mailing address
50 HAVEN AVE # 92, NEW YORK, NY 10032-2652
(347) 841-4147
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
029796
NY
Other
Enumeration date
02/15/2025
Last updated
02/15/2025
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