Healthcare Provider Details

I. General information

NPI: 1295853232
Provider Name (Legal Business Name): THERESA GETCHIUS OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # F1828B
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

323 FLATBUSH AVE # 2
BROOKLYN NY
11217-2813
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-1590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number014286
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: