Healthcare Provider Details

I. General information

NPI: 1487922100
Provider Name (Legal Business Name): CRISTINA MARIE KLYMASZ MS, OTR/L, CBIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-1424
US

IV. Provider business mailing address

1199 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052
US

V. Phone/Fax

Practice location:
  • Phone: 973-414-4718
  • Fax: 973-414-4738
Mailing address:
  • Phone: 973-414-4718
  • Fax: 973-414-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number46TR00532900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: