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NPI Code Detail

MEDICARE: ALYSSA MONACO OTR

MEDICARE: ALYSSA MONACO 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
1225X00000XOccupational Therapist46TR01078100NJ

General Provider Information

NPI Number : 1700543550
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MONACO OTR
Provider Business Mailing Address
First Line : 1455 BROAD ST STE 250
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3066
Country : US
Telephone Number : 877-532-7837
Fax Number :
Provider Business Practice Location Address
First Line : 2-22 BANTA PL
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-3058
Country : US
Telephone Number : 732-289-2540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2021
Last Update Date : 01/19/2026

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