Provider Demographics
NPI:1285835959
Name:KARMI GROSS, CORA (OTR L CHT)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:
Last Name:KARMI GROSS
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2293
Mailing Address - Country:US
Mailing Address - Phone:631-549-6994
Mailing Address - Fax:631-549-7203
Practice Address - Street 1:900 WALT WHITMAN RD
Practice Address - Street 2:SUITE 307
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2293
Practice Address - Country:US
Practice Address - Phone:631-549-6994
Practice Address - Fax:631-549-7203
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0026831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400062934Medicare PIN