Ellyn Gately, OT, PLLC

Organization Active NPI Occupational Therapist · Wading River, NY

NPI 1679016505 · NPPES record last updated Dec 8, 2016

Key facts

NPI
1679016505
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Therapist 225X00000X
Legal business name
ELLYN GATELY, OT, PLLC
Practice address
5 Salem CT
Wading River, NY 11792-2322
Phone
(631) 965-8992
NPI assigned
Nov 25, 2016
Organization subpart
No

Authorized official

Name
Ellyn C Gately
Title
Occupational Therapist
Phone
(631) 965-8992

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170105001176 NY Part B Supplier - Clinic/Group Practice 2860773827 Receives reassigned benefits from 1 practitioner
Practice locations: Wading River, NY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X Yes

Addresses

Primary practice location

5 Salem CT
Wading River, NY 11792-2322

Mailing address

5 Salem CT
Wading River, NY 11792-2322
Phone (631) 965-8992

Other providers in Wading River, NY

All providers in Wading River, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.