Healthcare Provider Details

I. General information

NPI: 1245134816
Provider Name (Legal Business Name): KRISTEN ALLYSE D'ELIA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N RTE 17 STE 110
PARAMUS NJ
07652-2824
US

IV. Provider business mailing address

140 N RTE 17 STE 110
PARAMUS NJ
07652-2824
US

V. Phone/Fax

Practice location:
  • Phone: 201-483-6371
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01311900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: