Provider Demographics
NPI:1114993219
Name:MOUNIC, GERARD (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:
Last Name:MOUNIC
Suffix:
Gender:M
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 1:145 E 15TH ST
Mailing Address - Street 2:APT 1J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3531
Mailing Address - Country:US
Mailing Address - Phone:917-553-2556
Mailing Address - Fax:
Practice Address - Street 1:145 E 15TH ST
Practice Address - Street 2:APT 1J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3531
Practice Address - Country:US
Practice Address - Phone:917-553-2556
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011820-1225XE1200X, 225XH1200X, 225XH1300X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Not Answered225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQU1851Medicare ID - Type UnspecifiedMEDICARE PROVIDER