Healthcare Provider Details

I. General information

NPI: 1023434115
Provider Name (Legal Business Name): PREETI TALREJA OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RED OAK DR
DOVER DE
19904-2368
US

IV. Provider business mailing address

125 RED OAK DR
DOVER DE
19904-2368
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-9271
  • Fax:
Mailing address:
  • Phone: 302-734-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberU1-0000841
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: