Individual
PAUL JOHN POLIVIOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
10 W END CT, LONG BRANCH, NJ 07740-5172
(732) 222-2219
Mailing address
72A BRIDGE AVE, RED BANK, NJ 07701-1160
(862) 219-8277
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01073600
NJ
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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