Provider Demographics
NPI:1063725463
Name:GERACE, ANTONINA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANTONINA
Middle Name:
Last Name:GERACE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 E 10TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2513
Mailing Address - Country:US
Mailing Address - Phone:347-228-3253
Mailing Address - Fax:
Practice Address - Street 1:8 E 10TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2513
Practice Address - Country:US
Practice Address - Phone:347-228-3253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012848-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics