Healthcare Provider Details

I. General information

NPI: 1447669551
Provider Name (Legal Business Name): CHAVA HAMBURGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 STRATFORD PL
LAKEWOOD NJ
08701-1467
US

IV. Provider business mailing address

132 STRATFORD PL
LAKEWOOD NJ
08701-1467
US

V. Phone/Fax

Practice location:
  • Phone: 248-417-7938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number46TR00632600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: