Provider Demographics
NPI:1962627406
Name:GELMAN, MARC D (MS OTRL)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:D
Last Name:GELMAN
Suffix:
Gender:M
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:55 NORTHERN BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4058
Mailing Address - Country:US
Mailing Address - Phone:516-466-9300
Mailing Address - Fax:516-466-9353
Practice Address - Street 1:55 NORTHERN BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4058
Practice Address - Country:US
Practice Address - Phone:516-466-9300
Practice Address - Fax:516-466-9353
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011913225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQT8071Medicare UPIN
NYGE0QT80710Medicare PIN