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General NPI Number Information
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NPI Number | 1124728563
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Entity Type | Individual
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Provider Name | KENDALL ROSE EDWARDS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 186 COLUMBIA TPKE
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1389
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Country | US
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Telephone | 973-718-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 452 GREEN POND RD
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City | ROCKAWAY
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State | NJ
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Zip | 07866-4227
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Country | US
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Telephone | 973-525-3467
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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 | 46TR00873500
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License Number State | NJ
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