Provider Demographics
NPI:1407649809
Name:POISSON, GLORIA (OTR/L)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:POISSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 102ND ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5635
Mailing Address - Country:US
Mailing Address - Phone:347-567-6238
Mailing Address - Fax:
Practice Address - Street 1:315 E 102ND ST APT 2R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5635
Practice Address - Country:US
Practice Address - Phone:347-567-6238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030231225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist