Individual
MR. ROSSELLE POBLETE GURANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1355 OAKLAND AVE, UNION, NJ 07083-5465
(908) 686-2932
Mailing address
1355 OAKLAND AVE, UNION, NJ 07083-5465
(908) 686-2932
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00466500
NJ
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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