Provider Demographics
NPI:1407314644
Name:STARSIAK, GABRIELA I (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:I
Last Name:STARSIAK
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 1:100 HUNTINGTON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-2517
Mailing Address - Country:US
Mailing Address - Phone:413-335-8205
Mailing Address - Fax:
Practice Address - Street 1:11 SAINT ANTHONY ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-2141
Practice Address - Country:US
Practice Address - Phone:413-315-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12948225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty