# GMD PHYSICAL & OCCUPATIONAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346428299
- **Authorized official:** MR. GIL M. DERSOVITZ PT, OTR/L (PRESIDENT)
- **Authorized official phone:** (866) 613-6801

## Contact information

- **Practice address:** 324 DONALDSON ST, HIGHLAND PARK, NJ 08904-2521
- **Practice address phone:** (866) 613-6801
- **Practice address fax:** (866) 734-1463
- **Mailing address:** 324 DONALDSON ST, HIGHLAND PARK, NJ 08904-2521
- **Mailing address phone:** (866) 613-6801
- **Mailing address fax:** (866) 734-1463

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 017930 | NY | Yes |
| 225100000X | Physical Therapist | 40QA01130400 | NJ | — |
| 225X00000X | Occupational Therapist | 012347 | NY | — |
| 225X00000X | Occupational Therapist | 46TR00382200 | NJ | — |

## Other

- **Enumeration date:** 02/02/2008
- **Last updated:** 02/02/2008