Healthcare Provider Details

I. General information

NPI: 1437466372
Provider Name (Legal Business Name): SHOSHANA GELMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 COPPERBEECH LN
LAWRENCE NY
11559-2605
US

IV. Provider business mailing address

27 COPPERBEECH LN
LAWRENCE NY
11559-2605
US

V. Phone/Fax

Practice location:
  • Phone: 516-569-1015
  • Fax: 516-569-4560
Mailing address:
  • Phone: 516-569-1015
  • Fax: 516-569-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003858-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: