Provider Demographics
NPI:1336413673
Name:GURSKY, CARINE (COTA/L)
Entity Type:Individual
Prefix:
First Name:CARINE
Middle Name:
Last Name:GURSKY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CARINE
Other - Middle Name:
Other - Last Name:GURSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:128 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1750
Mailing Address - Country:US
Mailing Address - Phone:484-464-8419
Mailing Address - Fax:
Practice Address - Street 1:2 GRACEDALE AVE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-8785
Practice Address - Country:US
Practice Address - Phone:610-746-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007232224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant