MEDICARE: SARAH BERG OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	46TR01196600	NJ

General Provider Information

NPI Number	:	1316772973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BERG OTR/L

Provider Business Mailing Address
First Line	:	308 E 7TH ST BSMT DOOR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-2007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 AVE OF THE STATES STE 301
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4791
Country	:	US
Telephone Number	:	844-390-6265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	09/04/2024

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Directions to “ SARAH BERG OTR/L” Practice Location

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