Individual
XAVIER ALDIANO SIBUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
83 JOHN PL, BERGENFIELD, NJ 07621-3325
(201) 981-9855
Mailing address
83 JOHN PL, BERGENFIELD, NJ 07621-3325
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009911-01
NY
Other
Enumeration date
09/18/2021
Last updated
09/18/2021
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