=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013490481
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHOSHANA GELMAN OCCUPATIONAL THERAPIST PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2018
-----------------------------------------------------
Last Update Date | 09/21/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 114 HARDS LN
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11559-1315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-569-1015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 COPPERBEECH LN
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11559-2605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-316-9174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OTR/L
-----------------------------------------------------
Name | SHOSHANA GELMAN
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 516-316-9174
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------