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NPI Code Detail

MEDICARE: MARY T. TROSSELLO OT

MEDICARE: MARY T. TROSSELLO OT
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 Therapist46TR00051500NJ

General Provider Information

NPI Number : 1902960222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY T. TROSSELLO OT
Provider Business Mailing Address
First Line : 2222 SULLIVAN TRL
Second Line :
City : EASTON
State : PA
Zip : 18040-7958
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 160 S MAIN ST
Second Line :
City : OCEAN GROVE
State : NJ
Zip : 07756-1013
Country : US
Telephone Number : 732-775-0554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 07/08/2007

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