Individual
GREGORY EDWARD CHARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
111 WABASH AVE, CARNEGIE, PA 15106-3050
(724) 469-3082
Mailing address
111 WABASH AVE, CARNEGIE, PA 15106-3050
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24325441
GATEWAY HEALTH
PA
Enumeration date
12/05/2017
Last updated
12/05/2017
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