MEDICARE: SHARI WEINER OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	46TR002473	NJ

General Provider Information

NPI Number	:	1396092441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI WEINER OTR

Provider Business Mailing Address
First Line	:	14 FOREST ST
Second Line	:	UNIT 101
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-3554
Country	:	US
Telephone Number	:	201-704-2819
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 ROUTE 3
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3928
Country	:	US
Telephone Number	:	862-591-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	08/08/2012

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Directions to “ SHARI WEINER OTR” Practice Location

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