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Organization
RISE PT OT SPEECH NUTRITION PLLC
Active
Organization
RISE PT OT SPEECH NUTRITION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA GORMEZANO (AUTHORIZED OFFICIAL)
(212) 974-7252
Entity
Organization
Contact information
Practice address
485 MADISON AVE STE 801, NEW YORK, NY 10022-5879
(212) 980-2963
Mailing address
485 MADISON AVE STE 801, NEW YORK, NY 10022-5879
(212) 980-2963
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/10/2025
Last updated
03/24/2026
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