Provider Demographics
NPI:1023383809
Name:STAMBONI, CARLA-MARIE (MS, MA, OTR/L, LCAT)
Entity Type:Individual
Prefix:MRS
First Name:CARLA-MARIE
Middle Name:
Last Name:STAMBONI
Suffix:
Gender:F
Credentials:MS, MA, OTR/L, LCAT
Other - Prefix:
Other - First Name:CARLA-MARIE
Other - Middle Name:
Other - Last Name:MERCUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDT, LCAT
Mailing Address - Street 1:3018 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5432
Mailing Address - Country:US
Mailing Address - Phone:917-699-6636
Mailing Address - Fax:
Practice Address - Street 1:6818 DELILAH RD
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9594
Practice Address - Country:US
Practice Address - Phone:609-453-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00869800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist