Provider Demographics
NPI:1427669977
Name:ZHAO, GABE (OTR/L)
Entity type:Individual
Prefix:
First Name:GABE
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
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 1:34 MONROE ST APT CA4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7733
Mailing Address - Country:US
Mailing Address - Phone:646-287-3468
Mailing Address - Fax:
Practice Address - Street 1:34 MONROE ST APT CA4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7733
Practice Address - Country:US
Practice Address - Phone:646-287-3468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024695-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist