Provider Demographics
NPI:1538519905
Name:GINA BARONE, O.T.,P.C.
Entity Type:Organization
Organization Name:GINA BARONE, O.T.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:718-939-5178
Mailing Address - Street 1:16404 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1440
Mailing Address - Country:US
Mailing Address - Phone:718-939-5178
Mailing Address - Fax:718-939-5178
Practice Address - Street 1:16404 33RD AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1440
Practice Address - Country:US
Practice Address - Phone:718-939-5178
Practice Address - Fax:718-939-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005976-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services