MEDICARE: GADI GEDALIAOU WININGER DPT

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
1	225100000X	Physical Therapist	PT021206	PA
2	225100000X	Physical Therapist	038772-1	NY
3	225100000X	Physical Therapist	PT013169	OH

General Provider Information

NPI Number	:	1568760130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GADI GEDALIAOU WININGER DPT

Provider Business Mailing Address
First Line	:	425 MAIN ST
Second Line	:	8S
City	:	NEW YORK
State	:	NY
Zip	:	10044-0238
Country	:	US
Telephone Number	:	216-798-9626
Fax Number	:

Provider Business Practice Location Address
First Line	:	4329 GREEN RD
Second Line	:
City	:	HIGHLAND HILLS
State	:	OH
Zip	:	44128-4884
Country	:	US
Telephone Number	:	216-385-6111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	02/25/2025

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