Organization
TONY AND AVA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN IACOVIELLO OTA (OWNER)
(973) 223-2950
Entity
Organization
Contact information
Practice address
320 S HARRISON ST APT 20H, EAST ORANGE, NJ 07018-1335
(973) 223-2950
Mailing address
320 S HARRISON ST APT 20H, EAST ORANGE, NJ 07018-1335
(973) 223-2950
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
09/15/2025
Last updated
01/26/2026
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