Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00609000 | NJ |
NPI | 1801210265 |
---|---|
Provider Name | Gianna Demarco |
First Address | Egg Harbor Township, NJ 08234-1609 |
Second Address | Little Egg Harbor Twp, NJ 08087-1347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2014 |
Last Update Date | 05/02/2014 |