Most Relevant Information
Provider Data
| NPI Number: | 1003633801 |
| Provider Name: | EVA DIANNE JEAN-GILLES |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 009354 |
Most Important Dates
| Enumeration Date: | 09/23/2024 |
| Last Updated: | 09/23/2024 |
Provider Practice Location
4275 65TH PL
WOODSIDE
NY
113775054
Practice Location Phone/Fax
| Phone: | 7185402142 |
| Fax: |
Provider Mailing Location
18311 HILLSIDE AVE APT 9L
JAMAICA
NY
114324851
Provider Mailing Phone/Fax
| Phone: | 9173192624 |
| Fax: |