Individual
MR. GERALD O IKEZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17330 113TH AVE, ADDISLEIGH PARK, NY 11433-4003
(718) 207-3292
Mailing address
17330 113TH AVE, ADDISLEIGH PARK, NY 11433-4003
(718) 207-3292
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007775-1
NY
Other
Enumeration date
12/27/2010
Last updated
12/27/2010
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