Provider Demographics
NPI:1003060419
Name:GESSNER, TARA (MA, OTR)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:GESSNER
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 JEWETT RD
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1039
Mailing Address - Country:US
Mailing Address - Phone:845-353-9026
Mailing Address - Fax:
Practice Address - Street 1:212 JEWETT RD
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1039
Practice Address - Country:US
Practice Address - Phone:845-353-9026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003730-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist