Individual
DERVAIN MATTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
981 US HIGHWAY 22, BRIDGEWATER, NJ 08807-2946
(201) 801-7141
Mailing address
981 US HIGHWAY 22, BRIDGEWATER, NJ 08807-2946
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
46TR01235300
NJ
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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