Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00457700 | NJ |
NPI | 1215169248 |
---|---|
Provider Name | Anna Marcelo |
First Address | Rahway, NJ 07065-2764 |
Second Address | Rahway, NJ 07065-2764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2009 |
Last Update Date | 09/05/2013 |