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NPI Code Detail

MEDICARE: ANASTASIA MARIE GENTZ OTR

MEDICARE: ANASTASIA MARIE GENTZ OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist3708-026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205002482
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANASTASIA MARIE GENTZ OTR
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 6735 W BRADLEY RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-3325
Country : US
Telephone Number : 414-354-3300
Fax Number : 414-354-7419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2008
Last Update Date : 05/15/2026

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Directions to “ ANASTASIA MARIE GENTZ OTR” Practice Location

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