=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699073684
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSEMARY A BURNETT OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2011
-----------------------------------------------------
Last Update Date | 07/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 MORRISTOWN RD ROUTE 202
-----------------------------------------------------
City | BERNARDSVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07924-2328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-766-1717
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18 S 4TH AVE
-----------------------------------------------------
City | MANVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08835-1812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-420-4714
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
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 | 46TR00288600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------