MEDICARE: ANDREA M TOMPOROWSKI OTR/L

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	46TR00365300	NJ

General Provider Information

NPI Number	:	1538284757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA M TOMPOROWSKI OTR/L

Provider Business Mailing Address
First Line	:	224 ARROWOOD WAY
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-3174
Country	:	US
Telephone Number	:	732-514-6578
Fax Number	:	732-514-6579

Provider Business Practice Location Address
First Line	:	2005 US HIGHWAY 22
Second Line	:
City	:	BOUND BROOK
State	:	NJ
Zip	:	08805-1523
Country	:	US
Telephone Number	:	732-302-4596
Fax Number	:	732-302-4595

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	10/04/2018

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