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General NPI Number Information
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NPI Number | 1285159764
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Entity Type | Individual
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Provider Name | JOANNA L GUGULSKI OT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 155 RIVERSIDE DR APT 1E
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City | NEW YORK
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State | NY
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Zip | 10024-2267
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Country | US
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Telephone | 646-256-0230
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Fax |
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Provider Business Mailing Address
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Address Line | 155 RIVERSIDE DR APT 1E
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City | NEW YORK
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State | NY
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Zip | 10024-2267
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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