Gabriel Bilello, COTA

Individual provider Active NPI Occupational Therapy Assistant · Buford, GA

NPI 1508217845 · NPPES record last updated Jun 28, 2016

Key facts

NPI
1508217845
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA.0000768 (CO)
Practice address
2727 Bogan Creek Dr
Buford, GA 30519-4517
Phone
(225) 266-4782
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA.0000768COMDOccupational Therapy Assistant
OTA001907GAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.0000768 CO Yes
Occupational Therapy Assistant 224Z00000X OTA001907 GA

Addresses

Primary practice location

2727 Bogan Creek Dr
Buford, GA 30519-4517

Mailing address

2727 Bogan Creek Dr
Buford, GA 30519-4517
Phone (225) 266-4782

Other providers in Buford, GA

All providers in Buford, GA · Occupational Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.