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Individual

SHIFRA JOSEPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
19 COLES WAY, LAKEWOOD, NJ 08701-4876
(848) 226-1572
Mailing address
40 STEVEN LN, LAKEWOOD, NJ 08701-1545
(848) 226-1572

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09139300
NJ
224ZE0001X
Environmental Modification Occupational Therapy Assistant
46TA09139300
NJ

Other

Enumeration date
03/18/2019
Last updated
03/18/2019
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