Provider Demographics
NPI:1144202896
Name:PRISTAS, SUSAN B (OT CHT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:B
Last Name:PRISTAS
Suffix:
Gender:F
Credentials:OT CHT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1259 ROUTE 46
Mailing Address - Street 2:BUILDING #3
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4909
Mailing Address - Country:US
Mailing Address - Phone:973-334-4321
Mailing Address - Fax:973-334-1095
Practice Address - Street 1:7 CEDAR GROVE LN
Practice Address - Street 2:SUITE 39
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1331
Practice Address - Country:US
Practice Address - Phone:732-469-5680
Practice Address - Fax:732-868-1422
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ46TR00136300225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056554NXZMedicare PIN