Provider Demographics
NPI:1770862807
Name:ZALI, GINA MARIE (PSY D, OTR/L)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:ZALI
Suffix:
Gender:F
Credentials:PSY D, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 MAIN ST STE 406
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5734
Mailing Address - Country:US
Mailing Address - Phone:716-202-2210
Mailing Address - Fax:716-720-2071
Practice Address - Street 1:5820 MAIN ST STE 406
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5734
Practice Address - Country:US
Practice Address - Phone:716-202-2210
Practice Address - Fax:716-720-2071
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-07
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021233103TH0004X, 103T00000X, 103TR0400X, 103G00000X, 103TR0400X
NY018773225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist