Provider Demographics
NPI:1285229617
Name:GOTTLIEB, TZIVIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TZIVIA
Middle Name:
Last Name:GOTTLIEB
Suffix:
Gender:F
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 1:66 ESTATE DR
Mailing Address - Street 2:
Mailing Address - City:FALLSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12733-5040
Mailing Address - Country:US
Mailing Address - Phone:845-707-2033
Mailing Address - Fax:
Practice Address - Street 1:66 ESTATE DR
Practice Address - Street 2:
Practice Address - City:FALLSBURG
Practice Address - State:NY
Practice Address - Zip Code:12733-5040
Practice Address - Country:US
Practice Address - Phone:845-707-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist