Provider Demographics
NPI:1083836753
Name:FREDHOFF, KAREN PAULINE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:PAULINE
Last Name:FREDHOFF
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 BOWERS AVE
Mailing Address - Street 2:
Mailing Address - City:RUNNEMEDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08078-1324
Mailing Address - Country:US
Mailing Address - Phone:856-931-5180
Mailing Address - Fax:
Practice Address - Street 1:541 BOWERS AVE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1324
Practice Address - Country:US
Practice Address - Phone:856-931-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09037500224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant