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NPI Code Detail

MEDICARE: OLGA GOMEZ OT

MEDICARE:   OLGA  GOMEZ  OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist012953-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1012953-1OTHERNYLICENSE#

General Provider Information

NPI Number : 1396836169
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA GOMEZ OT
Provider Business Mailing Address
First Line : 2555 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4730
Country : US
Telephone Number : 718-951-8800
Fax Number : 718-951-0846
Provider Business Practice Location Address
First Line : 2555 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4730
Country : US
Telephone Number : 718-951-8800
Fax Number : 718-951-0846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 04/30/2013

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Directions to “ OLGA GOMEZ OT” Practice Location

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