Healthcare Provider Details

I. General information

NPI: 1861910028
Provider Name (Legal Business Name): GAIL PAGUNTALAN OCAMPO PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16410 NORTHERN BLVD
FLUSHING NY
11358-2677
US

IV. Provider business mailing address

13410 JEWEL AVE
KEW GARDENS HILLS NY
11367-1918
US

V. Phone/Fax

Practice location:
  • Phone: 347-684-8241
  • Fax:
Mailing address:
  • Phone: 347-684-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number011079
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number044679-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: