Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 46TR00136300 | NJ |
NPI | 1144202896 |
---|---|
Provider Name | Mrs. Susan B Pristas |
First Address | Parsippany, NJ 07054-4909 |
Second Address | Somerset, NJ 08873-1331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 29/06/2010 |