Provider Demographics
NPI:1366848368
Name:OLYMPIA-GILLE, MARIA CLAUDIA
Entity Type:Individual
Prefix:
First Name:MARIA CLAUDIA
Middle Name:
Last Name:OLYMPIA-GILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 8TH AVE FL 6TH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3011
Mailing Address - Country:US
Mailing Address - Phone:917-434-4766
Mailing Address - Fax:
Practice Address - Street 1:4951 CHAMBERS STREET
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1209
Practice Address - Country:US
Practice Address - Phone:917-286-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018606-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist