Provider Demographics
NPI:1114238920
Name:ROBERTSON, GERTRUDE S (OTR)
Entity Type:Individual
Prefix:MRS
First Name:GERTRUDE
Middle Name:S
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 E 7TH ST
Mailing Address - Street 2:6K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5911
Mailing Address - Country:US
Mailing Address - Phone:917-697-7718
Mailing Address - Fax:347-787-2507
Practice Address - Street 1:599 E 7TH ST
Practice Address - Street 2:6K
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5911
Practice Address - Country:US
Practice Address - Phone:917-697-7718
Practice Address - Fax:347-787-2507
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist