Provider Demographics
NPI:1013288455
Name:CORA KARMI GROSS, OTR PC
Entity Type:Organization
Organization Name:CORA KARMI GROSS, OTR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CORA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARMI GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:631-549-6994
Mailing Address - Street 1:900 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2293
Mailing Address - Country:US
Mailing Address - Phone:631-549-6994
Mailing Address - Fax:631-549-7203
Practice Address - Street 1:900 WALT WHITMAN RD
Practice Address - Street 2:SUITE 307
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2293
Practice Address - Country:US
Practice Address - Phone:631-549-6994
Practice Address - Fax:631-549-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100062930Medicare PIN