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General NPI Number Information
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NPI Number | 1093128274
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Entity Type | Individual
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Provider Name | DIANE MARIE CERULLI OTR
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Gender | Female
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 919 DONCASTER DR
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City | WEST DEPTFORD
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State | NJ
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Zip | 08066-1911
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Country | US
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Telephone | 856-383-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 919 DONCASTER DR
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City | WEST DEPTFORD
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State | NJ
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Zip | 08066-1911
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Country | US
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Telephone | 856-383-9944
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 15761
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License Number State | FL
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