Provider Demographics
NPI:1467662320
Name:GAO, BETTY (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 N BROADWAY STE L100
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2674
Mailing Address - Country:US
Mailing Address - Phone:914-909-6970
Mailing Address - Fax:914-909-6971
Practice Address - Street 1:239 N BROADWAY STE L100
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2674
Practice Address - Country:US
Practice Address - Phone:914-909-6970
Practice Address - Fax:914-909-6971
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ27P81Medicare PIN