Healthcare Provider Details

I. General information

NPI: 1558736264
Provider Name (Legal Business Name): ROLI AURORA OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 CLIFTON AVE
CLIFTON NJ
07013-3518
US

IV. Provider business mailing address

1311 MAMARONECK AVE STE 140
WHITE PLAINS NY
10605-5224
US

V. Phone/Fax

Practice location:
  • Phone: 973-778-1134
  • Fax: 973-614-1530
Mailing address:
  • Phone: 888-830-4125
  • Fax: 631-580-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number020170
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberNJDCATEMP-010321
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00959000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: