Healthcare Provider Details

I. General information

NPI: 1629275466
Provider Name (Legal Business Name): DEBORAH CHILELLI-BORU OTR, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 BOOKER ST
WESTWOOD NJ
07675-2619
US

IV. Provider business mailing address

455 ABBOTT AVE
RIDGEFIELD NJ
07657
US

V. Phone/Fax

Practice location:
  • Phone: 201-822-0100
  • Fax: 201-822-0107
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00366000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: