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Individual

MRS. TRACY ANN LONCKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
301 N RANDOLPHVILLE RD, APT 42, PISCATAWAY, NJ 08854-3175
(646) 963-5559
Mailing address
301 N RANDOLPHVILLE RD, APT 42, PISCATAWAY, NJ 08854-3175
(646) 963-5559

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00654300
NJ
225XP0200X
Pediatric Occupational Therapist
017830
NY

Other

Enumeration date
03/07/2013
Last updated
01/26/2015
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