Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00719900 | NJ |
NPI | 1285092536 |
---|---|
Provider Name | Kaltrina Pacuku |
First Address | Voorhees, NJ 08043-1264 |
Second Address | Cherry Hill, NJ 08003-2334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2016 |
Last Update Date | 15/03/2016 |