Healthcare Provider Details

I. General information

NPI: 1760018766
Provider Name (Legal Business Name): NELLANEY CATHERINE OBRIEN OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 03/21/2020
Certification Date: 03/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MADISON AVE
MORRISTOWN NJ
07960-6097
US

IV. Provider business mailing address

14 ALEXANDER DR
RANDOLPH NJ
07869-4535
US

V. Phone/Fax

Practice location:
  • Phone: 973-683-2363
  • Fax:
Mailing address:
  • Phone: 201-400-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number46TR00491400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: