Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00379500 | NJ |
NPI | 1063904720 |
---|---|
Provider Name | Mr. Norman Torres |
First Address | Morristown, NJ 07960-7330 |
Second Address | Morristown, NJ 07960-7330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2018 |
Last Update Date | 30/05/2018 |