Provider Demographics
NPI:1255989802
Name:ROCHFORD, GABRIELA KOHAR MASOTTI (OTR/L)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:KOHAR MASOTTI
Last Name:ROCHFORD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:KOHAR
Other - Last Name:MASOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:101 JACKSON AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2726
Mailing Address - Country:US
Mailing Address - Phone:516-661-4092
Mailing Address - Fax:
Practice Address - Street 1:101 JACKSON AVE APT 3B
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2726
Practice Address - Country:US
Practice Address - Phone:516-661-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021236225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist