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Organization
CARECITY
Active
Organization
CARECITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ATHENA POONACHA BOLLERA (CEO)
(732) 877-4799
Entity
Organization
Contact information
Practice address
21 MORAINE RD, EDISON, NJ 08820-3663
(732) 877-4799
(862) 322-6598
Mailing address
21 MORAINE RD, EDISON, NJ 08820-3663
(732) 877-4799
(862) 322-6598
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
225XL0004X
Low Vision Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/07/2023
Last updated
04/19/2024
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