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Organization

CARECITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS ATHENA POONACHA BOLLERA (CEO)
(732) 877-4799
Entity
Organization

Contact information

Practice address
21 MORAINE RD, EDISON, NJ 08820-3663
(732) 877-4799
(862) 322-6598
Mailing address
21 MORAINE RD, EDISON, NJ 08820-3663
(732) 877-4799
(862) 322-6598

Taxonomy

Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
2251G0304X
Geriatric Physical Therapist
2251N0400X
Neurology Physical Therapist
2251P0200X
Pediatric Physical Therapist
2251S0007X
Sports Physical Therapist
2251X0800X
Orthopedic Physical Therapist
225200000X
Physical Therapy Assistant
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
225XG0600X
Gerontology Occupational Therapist
225XL0004X
Low Vision Occupational Therapist
225XM0800X
Mental Health Occupational Therapist
225XN1300X
Neurorehabilitation Occupational Therapist
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
08/07/2023
Last updated
04/19/2024
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