Healthcare Provider Details

I. General information

NPI: 1013825223
Provider Name (Legal Business Name): KATHERINE A GRIBBON COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 PARROTT RD
WEST NYACK NY
10994-1025
US

IV. Provider business mailing address

11 SHORT PL
RINGWOOD NJ
07456-2124
US

V. Phone/Fax

Practice location:
  • Phone: 845-627-4700
  • Fax:
Mailing address:
  • Phone: 845-659-3176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number010025
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: