Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
Y | 225XH1200X | Occupational Therapist - Hand |
NPI | 1013446368 |
---|---|
Provider Name | Pauline Nicole Gasparro |
First Address | Rockaway, NJ 07866-4134 |
Second Address | Somerset, NJ 08873-1331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2017 |
Last Update Date | 09/06/2017 |