Individual
SAMANTHA MARIE ORTOLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 MARTER AVE, MOORESTOWN, NJ 08057-3114
(856) 291-4800
Mailing address
590 N ATLANTIC AVE APT 313, COLLINGSWOOD, NJ 08108-3427
(215) 510-8784
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09201400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O76366877456884
DRIVERS LICENSE
NJ
Enumeration date
02/02/2021
Last updated
02/02/2021
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