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General NPI Number Information
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NPI Number | 1366885303
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Entity Type | Individual
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Provider Name | ELLEN L PERSECHINO O.T.R
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Gender | Female
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 42 OAKDALE RD
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City | CHESTER
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State | NJ
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Zip | 07930-2208
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Country | US
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Telephone | 908-879-4292
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Fax | 908-879-8422
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Provider Business Mailing Address
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Address Line | 42 OAKDALE RD
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City | CHESTER
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State | NJ
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Zip | 07930-2208
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Country | US
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Telephone | 908-879-4292
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Fax | 908-879-8422
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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 | 46TR00005400
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License Number State | NJ
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