=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437797982
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE LOUISE GARES OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2019
-----------------------------------------------------
Last Update Date | 01/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1060 MAIN ST
-----------------------------------------------------
City | RIVER EDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07661-2591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-833-0234
-----------------------------------------------------
Fax | 201-645-4735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1060 MAIN ST
-----------------------------------------------------
City | RIVER EDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07661-2591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-833-0234
-----------------------------------------------------
Fax | 201-645-4735
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 46TR00043300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------