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NPI Code Detail

MEDICARE: LAURA SHIELDS MS OTR/L

MEDICARE: LAURA SHIELDS MS 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
1225X00000XOccupational Therapist46TR00912500NJ

General Provider Information

NPI Number : 1952072522
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA SHIELDS MS OTR/L
Provider Business Mailing Address
First Line : 1104 ARNOLD AVE
Second Line :
City : POINT PLEASANT BORO
State : NJ
Zip : 08742-2388
Country : US
Telephone Number : 732-714-0070
Fax Number :
Provider Business Practice Location Address
First Line : 1104 ARNOLD AVE
Second Line :
City : POINT PLEASANT BORO
State : NJ
Zip : 08742-2388
Country : US
Telephone Number : 732-714-0070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 09/23/2021

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Directions to “ LAURA SHIELDS MS OTR/L” Practice Location

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