Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 46TA09151000 | NJ |
NPI | 1023510237 |
---|---|
Provider Name | Mrs. Vrunda Shankar |
First Address | Hillsborough, NJ 08844-1153 |
Second Address | Skillman, NJ 08558-2028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2018 |
Last Update Date | 03/03/2018 |