Individual
MISS NERISSA FE CORPUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1155 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-1498
(973) 731-5100
Mailing address
168 NOLTON ST, BELLEVILLE, NJ 07109-2332
(973) 336-0540
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09204300
NJ
225XP0019X
Physical Rehabilitation Occupational Therapist
46TA09204300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117957772
—
NJ
Enumeration date
06/02/2021
Last updated
06/02/2021
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