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General NPI Number Information
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NPI Number | 1578660270
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Entity Type | Individual
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Provider Name | MILYNN GAMBOA NAPOLIS AS,COTA/L
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Gender | Female
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1965 WILLIAMSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10461-1604
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Country | US
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Telephone | 718-409-6977
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Fax |
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Provider Business Mailing Address
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Address Line | 3097 41ST ST 3RD FLOOR
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City | ASTORIA
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State | NY
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Zip | 11103-3431
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Country | US
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Telephone | 718-937-7943
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 4666-1
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License Number State | NY
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