Provider Demographics
NPI:1750396776
Name:TREZZA, GINA T (MA, ATR, CASAC, CAT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:T
Last Name:TREZZA
Suffix:
Gender:F
Credentials:MA, ATR, CASAC, CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MIDDLEVILLE RD BLDG 6
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2200
Mailing Address - Country:US
Mailing Address - Phone:631-261-4400
Mailing Address - Fax:631-266-6099
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2290
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6099
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000832-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist