Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00344900 | NJ |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC012406 | PA |
NPI | 1205186665 |
---|---|
Provider Name | Mr. Randy F Marti |
First Address | Livingston, NJ 07039-1623 |
Second Address | Livingston, NJ 07039-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 13/09/2012 |