Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 003730-1 | NY |
NPI | 1003060419 |
---|---|
Provider Name | Tara Gessner |
First Address | Nyack, NY 10960-1039 |
Second Address | Nyack, NY 10960-1039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2008 |
Last Update Date | 11/08/2010 |