Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00764800 | NJ |
NPI | 1134332687 |
---|---|
Provider Name | Susan Marinoff |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 16/04/2019 |