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NPI 1699913954

NPI 1699913954 : SANDRA CHALIK MS OTR/L : MARLTON, NJ

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General NPI Number Information
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    NPI Number           |    1699913954
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    Entity Type          |    Individual 
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    Provider Name        |    SANDRA CHALIK MS OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/25/2009
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    Last Update Date     |    01/25/2009
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Provider Practice Location Address
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    Address Line         |    475 OLD MARLTON PIKE W STE 1 
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    City                 |    MARLTON
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    State                |    NJ
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    Zip                  |    08053-2098
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    Country              |    US
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    Telephone            |    856-983-6160
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    Fax                  |    856-983-6162
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Provider Business Mailing Address
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    Address Line         |    475 OLD MARLTON PIKE W STE 1 
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    City                 |    MARLTON
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    State                |    NJ
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    Zip                  |    08053-2098
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    Country              |    US
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    Telephone            |    856-983-6160
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    Fax                  |    856-983-6162
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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       |    OC008395
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    46TR00296200
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    License Number State |    NJ
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