Provider Demographics
NPI:1427293604
Name:GERBER, MELISSA KAYE
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAYE
Last Name:GERBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1721
Mailing Address - Country:US
Mailing Address - Phone:516-681-1423
Mailing Address - Fax:516-681-5244
Practice Address - Street 1:42 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1721
Practice Address - Country:US
Practice Address - Phone:516-681-1423
Practice Address - Fax:516-681-5244
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist