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NPI Code Detail

MEDICARE: GISELLE CALDERON OT

MEDICARE: GISELLE CALDERON 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 Therapist030271NY

General Provider Information

NPI Number : 1629951819
Entity Type Code : Individual
Provider Name (Legal Business Name) : GISELLE CALDERON OT
Provider Business Mailing Address
First Line : 11 FREEMAN PL
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-2716
Country : US
Telephone Number : 347-838-1899
Fax Number :
Provider Business Practice Location Address
First Line : 1441 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3779
Country : US
Telephone Number : 718-303-9777
Fax Number : 718-303-9778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2025
Last Update Date : 07/28/2025

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