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General NPI Number Information
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NPI Number | 1417771098
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Entity Type | Individual
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Provider Name | COLLEEN BRIANA GASKIN MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 39 FOREST AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-2107
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Country | US
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Telephone | 516-656-0575
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Fax |
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Provider Business Mailing Address
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Address Line | 817 HARRIAD DR W
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City | SEAFORD
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State | NY
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Zip | 11783-1207
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Country | US
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Telephone | 516-673-5553
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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