Healthcare Provider Details

I. General information

NPI: 1396989075
Provider Name (Legal Business Name): ANDREA ROSE DELMONICO MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GODWIN AVE SUITE 120
MIDLAND PARK NJ
07432-1444
US

IV. Provider business mailing address

700 GODWIN AVE SUITE 120
MIDLAND PARK NJ
07432-1444
US

V. Phone/Fax

Practice location:
  • Phone: 201-447-0303
  • Fax:
Mailing address:
  • Phone: 201-447-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number46TR00411900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number014561-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00411900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number014561-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number46TR00411900
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number014561-1
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number014561-1
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number46TR00411900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: