Provider Demographics
NPI:1205354115
Name:VISLEY, JAMESDEAN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JAMESDEAN
Middle Name:
Last Name:VISLEY
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 AVENUE P FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1105
Mailing Address - Country:US
Mailing Address - Phone:724-787-7495
Mailing Address - Fax:
Practice Address - Street 1:155 BAY RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5108
Practice Address - Country:US
Practice Address - Phone:718-238-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist