Basic Information
Provider Information
NPI: 1427643154
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAIMARO
FirstName: GABRIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 910 FREDERICK RD
Address2:  
City: CATONSVILLE
State: MD
PostalCode: 212284516
CountryCode: US
TelephoneNumber: 4106441880
FaxNumber:  
Practice Location
Address1: 910 FREDERICK RD
Address2:  
City: CATONSVILLE
State: MD
PostalCode: 212284516
CountryCode: US
TelephoneNumber: 4106441880
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/04/2021
LastUpdateDate: 06/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X09229MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home