Provider Demographics
NPI:1598994626
Name:GEWIRTZ, MIRIAM (MS OTR/L)
Entity type:Individual
Prefix:MR
First Name:MIRIAM
Middle Name:
Last Name:GEWIRTZ
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14716 71ST RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2011
Mailing Address - Country:US
Mailing Address - Phone:718-544-0595
Mailing Address - Fax:
Practice Address - Street 1:14716 71ST RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2011
Practice Address - Country:US
Practice Address - Phone:718-544-0595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics