Provider Demographics
NPI:1588263065
Name:GAETA, KATHERINE ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:GAETA
Suffix:
Gender:
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 1:1305 PATERSON PLANK RD APT 4402
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-1897
Mailing Address - Country:US
Mailing Address - Phone:347-308-3203
Mailing Address - Fax:
Practice Address - Street 1:1305 PATERSON PLANK RD APT 4402
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-1897
Practice Address - Country:US
Practice Address - Phone:347-308-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2025-03-06
Deactivation Date:2020-10-26
Deactivation Code:
Reactivation Date:2020-11-04
Provider Licenses
StateLicense IDTaxonomies
NY025117225X00000X
PAOC019820225X00000X
DEU1-0012268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist