Organization
SHORE KIDS PEDIATRIC THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY JILL GARGUILO (OCCUPATIONAL THERAPIST/CO-OWNER)
(732) 460-1500
Entity
Organization
Contact information
Practice address
14 BRIDGEWATERS DR, OCEANPORT, NJ 07757
(732) 460-1500
(732) 460-1501
Mailing address
14 BRIDGEWATERS DR, OCEANPORT, NJ 07757-1162
(732) 460-1500
(732) 460-1501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46TR00397400
NJ
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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