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Individual

GABRIELLA NUSSBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
10 BROOKFALL RD, EDISON, NJ 08817-2947
(732) 777-0193
Mailing address
10 BROOKFALL RD, EDISON, NJ 08817-2947
(732) 777-0193

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
017656-1
NY
225X00000X
Occupational Therapist
07021
MD
225X00000X
Occupational Therapist
46TR00596500
NJ

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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