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NPI 1861897878

NPI 1861897878 : MELISSA LANGEWISCH OT : LYNDHURST, NJ

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General NPI Number Information
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    NPI Number           |    1861897878
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA LANGEWISCH OT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2014
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    Last Update Date     |    01/17/2024
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Provider Practice Location Address
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    Address Line         |    724 RIDGE RD 
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    City                 |    LYNDHURST
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    State                |    NJ
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    Zip                  |    07071-3216
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    Country              |    US
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    Telephone            |    201-500-9812
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    Fax                  |    201-500-9812
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Provider Business Mailing Address
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    Address Line         |    724 RIDGE RD 
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    City                 |    LYNDHURST
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    State                |    NJ
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    Zip                  |    07071-3216
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    Country              |    US
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    Telephone            |    201-500-9812
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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       |    46TR00065500
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    License Number State |    NJ
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