Provider Demographics
NPI:1083487839
Name:SANTOMO, GEENA MARIE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:GEENA
Middle Name:MARIE
Last Name:SANTOMO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TWIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4131
Mailing Address - Country:US
Mailing Address - Phone:973-714-9265
Mailing Address - Fax:
Practice Address - Street 1:21 PINE ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3130
Practice Address - Country:US
Practice Address - Phone:973-586-8396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01154500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist