Provider Demographics
NPI:1477798163
Name:GHANOONI, GALIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:GALIA
Middle Name:
Last Name:GHANOONI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2842
Mailing Address - Country:US
Mailing Address - Phone:718-288-9038
Mailing Address - Fax:718-253-7415
Practice Address - Street 1:850 E 27TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2842
Practice Address - Country:US
Practice Address - Phone:718-288-9038
Practice Address - Fax:718-253-7415
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013443-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics