Provider Demographics
NPI:1922366673
Name:GOGLIORMELLA, PAOLA (MS OTR)
Entity Type:Individual
Prefix:MRS
First Name:PAOLA
Middle Name:
Last Name:GOGLIORMELLA
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2404
Mailing Address - Country:US
Mailing Address - Phone:914-772-2837
Mailing Address - Fax:
Practice Address - Street 1:489 SIWANOY PL
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-2420
Practice Address - Country:US
Practice Address - Phone:914-738-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014451-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics