Provider Demographics
NPI:1891466587
Name:GURVICH, REINA (OTR)
Entity Type:Individual
Prefix:
First Name:REINA
Middle Name:
Last Name:GURVICH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:REINA
Other - Middle Name:B
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:208 PROSPECT PARK W APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5713
Mailing Address - Country:US
Mailing Address - Phone:510-495-5694
Mailing Address - Fax:
Practice Address - Street 1:208 PROSPECT PARK W APT 2C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5713
Practice Address - Country:US
Practice Address - Phone:510-495-5694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist