Individual
AMANDA RAE GAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1772 E JERICHO TPKE, HUNTINGTON, NY 11743-5763
(631) 368-2583
(631) 368-5357
Mailing address
1159 5TH AVE, EAST NORTHPORT, NY 11731-2632
(631) 944-2479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
026495
NY
225XP0200X
Pediatric Occupational Therapist
026495
NY
Other
Enumeration date
01/15/2022
Last updated
01/15/2022
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