Provider Demographics
NPI:1043828486
Name:PRESTIPINO, GINETTE (COTA)
Entity Type:Individual
Prefix:
First Name:GINETTE
Middle Name:
Last Name:PRESTIPINO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2229
Mailing Address - Country:US
Mailing Address - Phone:845-376-9677
Mailing Address - Fax:
Practice Address - Street 1:105 S HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-2229
Practice Address - Country:US
Practice Address - Phone:845-376-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010530-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant