Provider Demographics
NPI:1932783214
Name:GELL, STEPHEN M (AAS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:GELL
Suffix:
Gender:M
Credentials:AAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 HOLLAND AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2354
Mailing Address - Country:US
Mailing Address - Phone:917-921-2139
Mailing Address - Fax:
Practice Address - Street 1:2125 HOLLAND AVE APT 1E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2354
Practice Address - Country:US
Practice Address - Phone:917-921-2139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010535224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant