Healthcare Provider Details

I. General information

NPI: 1619899432
Provider Name (Legal Business Name): M.DWYER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 SHORE RD
UNION BEACH NJ
07735-3225
US

IV. Provider business mailing address

511 SHORE RD
UNION BEACH NJ
07735-3225
US

V. Phone/Fax

Practice location:
  • Phone: 908-770-2186
  • Fax:
Mailing address:
  • Phone: 908-770-2186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MORGAN DWYER
Title or Position: OWNER
Credential: OTR/L
Phone: 908-770-2186