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Individual

ELYSE SHAHBAZIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1260 CENTENNIAL AVE, PISCATAWAY, NJ 08854-4332
(732) 204-0678
Mailing address
200 CENTRAL AVE, MOUNTAINSIDE, NJ 07092-1926

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00920400
NJ

Other

Enumeration date
07/23/2020
Last updated
07/24/2020
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