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General NPI Number Information
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NPI Number | 1891818373
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Entity Type | Individual
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Provider Name | ELLEN JANE GOLD OTR
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 51-55 N ROUTE 9W
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City | WEST HAVERSTRAW
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State | NY
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Zip | 10993
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Country | US
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Telephone | 845-786-4343
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Fax | 845-786-4051
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Provider Business Mailing Address
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Address Line | 9 MAGNOLIA DR
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City | RYE BROOK
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State | NY
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Zip | 10573-1821
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Country | US
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Telephone | 914-939-1034
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 002710-1
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License Number State | NY
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