Individual
MARY BRYDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6612 BERGENLINE AVE, WEST NEW YORK, NJ 07093-1719
(201) 861-0182
Mailing address
77 BROOK AVE APT F2, PASSAIC, NJ 07055-5372
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00632700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR00632700
NEW JERSEY OCCUPATIONAL THERAPY COUNCIL
NJ
Enumeration date
08/19/2015
Last updated
08/19/2015
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