Provider Demographics
NPI:1093144677
Name:SALVITTI, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SALVITTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9306
Mailing Address - Country:US
Mailing Address - Phone:856-357-0315
Mailing Address - Fax:856-582-9700
Practice Address - Street 1:128 BRANCH RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9306
Practice Address - Country:US
Practice Address - Phone:856-357-0315
Practice Address - Fax:856-582-9700
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA0903700224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant