Provider Demographics
NPI:1982765376
Name:GENTILE OT HAND CLINIC INC.
Entity Type:Organization
Organization Name:GENTILE OT HAND CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GENTILE
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:717-646-0440
Mailing Address - Street 1:1010 EICHELBERGER ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1374
Mailing Address - Country:US
Mailing Address - Phone:717-646-0440
Mailing Address - Fax:717-646-0444
Practice Address - Street 1:1010 EICHELBERGER ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1374
Practice Address - Country:US
Practice Address - Phone:717-646-0440
Practice Address - Fax:717-646-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1323140001Medicare NSC