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Individual

AGNES ROSZKOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
104 PENSION RD, MANALAPAN, NJ 07726-8400
(732) 446-3600
Mailing address
43 W 42ND ST, BAYONNE, NJ 07002-3061
(201) 377-5531

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09168400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46TA09168400
STATE OF NEW JERSEY
NJ
Enumeration date
02/20/2019
Last updated
02/20/2019
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