Individual
GREGORY RA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
150 RIVERSIDE DR, NEW YORK, NY 10024-2298
(646) 505-3500
Mailing address
2112 WINDSOR PARK CT, ENGLEWOOD, NJ 07631-4977
(646) 552-3028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009953
NY
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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