Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00532900 | NJ |
NPI | 1487922100 |
---|---|
Provider Name | Cristina Marie Klymasz |
First Address | West Orange, NJ 07052 |
Second Address | West Orange, NJ 07052-1424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2011 |
Last Update Date | 08/12/2011 |