Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00807400 | NJ |
NPI | 1295325850 |
---|---|
Provider Name | Alyssa Scala |
First Address | Teaneck, NJ 07666-4245 |
Second Address | Teaneck, NJ 07666-4245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2021 |
Last Update Date | 19/01/2021 |