Basic Information
Provider Information
NPI: 1992320717
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEINSTOCK-ZLOTNICK
FirstName: GWEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PH.D., OTR/L, CHT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 2126061000
FaxNumber:  
Practice Location
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 2126061660
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/09/2020
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X46TR00555000NJN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225XH1200X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
225X00000X008627-1NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home