Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00544100 | NJ |
NPI | 1063706257 |
---|---|
Provider Name | Ms. Teresa A. Skalko |
First Address | Saddle Brook, NJ 07663-5309 |
Second Address | Saddle Brook, NJ 07663-5309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2011 |
Last Update Date | 13/10/2020 |